Timing of blood pressure medications and intradialytic hypotension.
Timing of blood pressure medications and intradialytic hypotension.
复制标题
降血压药物和透析中低血压的时机。
DOI：
10.1111/sdi.12777
复制
发表时间：
2019
影响因子：
1.6
通讯作者：
Chang,TaraI
中科院分区：
文献类型：
--
作者：
Wang,KatherineM;Sirich,TammyL;Chang,TaraI
透析中低血压（IDH）是血液透析的一种常见但严重的并发症，与生活质量下降、透析不充分、血管通路血栓形成、全身灌注不足以及心血管和全因死亡率增加相关。目前的指南建议抗高血压药物应在夜间给予，并在受影响的患者透析的早晨进行。尽管几乎没有证据支持这一建议，但超过一半的透析患者可能会采用某种形式的这种方法。在这篇文章中，我们将审查有关血压药物的时间和IDH的发生的现有证据和临床考虑，并得出结论，血液透析前停用BP药物不应该是一种常规做法。
Intradialytic hypotension (IDH) is a prevalent yet serious complication of hemodialysis, associated with decreased quality of life, inadequate dialysis, vascular access thrombosis, global hypoperfusion, and increased cardiovascular and all‐cause mortality. Current guidelines recommend antihypertensive medications be given at night and held the morning of dialysis for affected patients. Despite little evidence to support this recommendation, more than half of patients on dialysis may employ some form of this method. In this article, we will review the available evidence and clinical considerations regarding timing of blood pressure medications and occurrence of IDH, and conclude that witholding BP medications before hemodialysis should not be a routine practice.