Blood pressure control and symptomatic intradialytic hypotension in diabetic haemodialysis patients: A cross-sectional survey
Blood pressure control and symptomatic intradialytic hypotension in diabetic haemodialysis patients: A cross-sectional survey
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DOI：
10.1159/000139991
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发表时间：
2008-01-01
影响因子：
--
通讯作者：
Thuraisingham, Raj
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文献类型：
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作者：
Davenport, Andrew;Cox, Claire;Thuraisingham, Raj
背景：心血管疾病仍然是终末期肾功能衰竭合并糖尿病患者最常见的死亡原因。为了改善血压控制，降低心血管风险，英国肾脏协会标准委员会在2002年引入了透析前和透析后的目标血压分别为<；140/90和<；130/80 mm Hg。方法：我们在大伦敦市区的11个肾中心对2,193名患者的1周内的血压控制和症状性透析中低血压进行了审计，包括6,579次血液透析。结果：尽管658名糖尿病患者中73.9%的患者服用了降压药，而1535名非糖尿病患者的这一比例为57.8%(p<；(0.001)，糖尿病患者透析前和透析后的平均血压均较高：透析前152±/-23/77+/-13对144+/-23/79+/-13 mm Hg，透析后138+/-24/71+/-12对132+/-26/73+/-13 mm Hg，较少的糖尿病患者达到透析前和透析后的血压目标分别为28.6比40.8%和37.9比46.3%(p<；0.01)。此外，更多的糖尿病患者在透析中出现症状性低血压，分别为20.3%和14.9%(p<；0.01)，与更大的透析间体重增加相关。结论：糖尿病血液透析患者透析前和透析后血压均较高，透析间期体重增加较多，出现症状性透析中低血压的频率较高。版权所有(C)2008 S.Karger AG，巴塞尔。
Background: Cardiovascular disease remains the most common cause of mortality in end-stage kidney failure patients with diabetes. To improve blood pressure control, and reduce cardiovascular risk, in 2002 the UK Renal Association Standards' Committee introduced pre- and post-dialysis target blood pressures of < 140/90 and < 130/80 mm Hg, respectively. Methods: We audited blood pressure control and symptomatic intradialytic hypotension during 1 week in the eleven renal centres in the Greater London Urban Area in 2,193 patients, capturing 6,579 haemodialysis sessions. Results: Although 73.9% of the 658 diabetic patients were prescribed antihypertensive medications, compared to 57.8% of the 1,535 non-diabetic patients (p < 0.001), both the mean pre- and post-dialysis blood pressures were greater in the diabetic patients: before dialysis 152 +/- 23/77 +/- 13 versus 144 +/- 23/79 +/- 13 mm Hg and after dialysis 138 +/- 24/71 +/- 12 versus 132 +/- 26/73 +/- 13 mm Hg, and fewer diabetic patients achieved the pre- and post-dialysis blood pressure targets: 28.6 versus 40.8% and 37.9 versus 46.3%, respectively (p < 0.01). In addition, more diabetic patients suffered symptomatic intradialytic hypotension, 20.3 versus 14.9% (p < 0.01), associated with greater interdialytic weight gains. Conclusion: Diabetic haemodialysis patients had higher blood pressures, both before and after dialysis, associated with greater interdialytic weight gains and more frequent symptomatic intradialytic hypotension. Copyright (C) 2008 S. Karger AG, Basel.