慢性肾脏病患者降压治疗的挑战与新进展  

Management of hypertension in patients with chronic kidney disease

作　　者：安玉[1] 梁菊[1] 刘志红[1] 

机构地区：[1]南京军区南京总医院肾脏科国家肾脏疾病临床医学研究中心全军肾脏病研究所,南京210016

出　　处：《肾脏病与透析肾移植杂志》2016年第6期548-552,共5页Chinese Journal of Nephrology,Dialysis & Transplantation

基　　金：国家科技支撑计划课题(2015BAI12B05);第一批国家临床重点专科项目(2014ZDZK001)

摘　　要：高血压是慢性肾脏病的常见临床表现,也是肾脏疾病进展的主要危险因素。慢性肾脏病患者往往存在动脉硬化、自主神经功能紊乱、容量负荷过重等因素,或合并应用干扰降压疗效的药物,从而导致难治性高血压的患病率增加。新近发表的收缩压干预试验为强化降压治疗后心血管获益提供了新的循证医学证据,但其在肾脏远期预后中的作用并不明确。不同降压治疗策略对慢性肾脏病患者预后的影响尚需更多大样本、长期随访的临床试验进一步确定。hypertension is a common clinical manifestation of chronic kidney disease,as well as a major risk factor for the progression of renal disease. Chronic kidney disease is associated with premature vascular aging,autonomic dysfunction and subclinical volume overload. The concommittent use of other agents that interfere with antihypertensive treatment is also very common in these patients,leading to an increased prevalence of resistant hypertension. Recently the Systolic Blood Pressure Intervention Trial provided new evidence of benefits of intensive hypertension control in cardiovascular disease. However,the effects of the lower blood pressure on the long-term renal outcome remain unclear. The optimal target blood pressure to reduce hypertension-related adverse in chronic kidney disease needs to be further explored in more large,and definitive clinical trials.

关 键 词：慢性肾脏病 高血压 难治性高血压 收缩压干预试验 

分 类 号：R692[医药卫生—泌尿科学] R544.1[医药卫生—外科学]