Ckd患者抗高血压药物的评价

N. D. Devi, M. Priyanka, A. Swathi, Jasti.Krishna Sai, Kishore Babu
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引用次数: 0

摘要

高血压在血液透析患者中很常见,并且通常难以控制。考虑到血液透析患者心血管负担高,控制血压对改善预后很重要。本研究旨在评估抗高血压药物在慢性肾脏疾病(CKD)患者中的治疗效果。这是一项前瞻性观察性研究,包括CKD合并T2DM和HTN等合并症患者的信息,在15名患者中进行,年龄在20岁以上至80岁之间,男性和女性均有。计算这15例患者的GFR,并确定CKD的严重程度分期。T2DM和高血压患者大多被诊断为CKD。循环利尿剂(速尿)+钙通道阻滞剂(氨氯地平)这种组合被开得更多,对CKD患者来说是安全的,因为这种组合不需要调整剂量。在我们的研究中,15例CKD患者中包括7例透析患者,大多数患者通过降压联合治疗控制了收缩压。急性心肌梗死1-3例。它们仍然是心血管(CV)疾病患者的一线治疗方法。同样,在糖尿病和非糖尿病肾病患者中,几项大型试验已经证明了它们在减少蛋白尿和延缓慢性肾病进展方面的有效性。与ACEI和ARB使用相关的主要不良反应是高钾血症、肾小球滤过率(GFR)降低和促红细胞生成素抵抗。在非透析人群中,高钾血症的风险随着GFR降低的程度而增加4。透析患者中最常见的血压模式是收缩期高血压,由于动脉粥样硬化性僵硬而伴有宽脉压。透析患者高血压的主要致病机制。细胞外液负荷是高血压透析患者最常见的特征。事实上,容量清除不足往往是导致透析难治性高血压的主要因素
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessment of Anti Hypertensive Drugs In Ckd Patients
Hypertension is common in hemodialysis patients and can often be difficult to control. Considering the high cardiovascular burden in hemodialysis patients, control of blood pressure is important to improve outcomes. This study is conducted to assess the anti hypertensive drugs treatment in chronic kidney disease (CKD) patients. This is a prospective observational study and includes information regarding CKD patients with co-morbidities like T2DM and HTN and it is conducted among 15 patients which were of both males and females of above 20 yrs of age upto 80 yrs. For these 15 patients e GFR is calculated and stage of severity of CKD was found. Patients with T2DM and Hypertensive are mostly diagnosed with CKD. Loop diuretic (Furosemide)+ calcium channel blocker (Amlodipine) this combination is prescribed more which is found to be safe for CKD patients as for this combination dosage adjustment is not required. In our study among 15 CKD patients 7 dialysis patients were included, majority of the patients have controlled SBP with the anti- hypertensive combinations. acute myocardial infarction 1-3 . They remain the firstline therapy for patients with cardiovascular (CV) disease. Similarly, in patients with diabetic and non-diabetic kidney disease, several large trials have demonstrated their effectiveness in reducing proteinuria and delaying progression of chronic kidney disease. The major adverse effects associated with ACEI and ARB use are hyperkalemia, decrease in glomerular filtration rate (GFR), and erythropoietin resistance. The risk of hyperkalemia increases with the degree of decrease in GFR in the nondialysis population 4 . The most common pattern of BP in dialysis patients is systolic hypertension associated with a wide pulse pressure due to atherosclerotic arterial stiffness. The main pathogenic mechanisms of hypertension in dialysis patients. Extracellular fluid overload is the most common feature in hypertensive dialysis patients. Indeed, insufficient volume removal is often the major factor responsible for dialysis-refractory hypertension 5-9
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