文章摘要

不同血压控制水平对腹膜透析患者残余肾功能和心血管事件风险的影响

作者: 1杨明榴
1 池州市人民医院肾内科,安徽 池州 247000
通讯: 杨明榴 Email: 2459776871@qq.com
DOI: 10.3978/j.issn.2095-6959.2021.09.008

摘要

目的:探讨不同血压控制水平对腹膜透析(peritoneal dialysis,PD)患者残余肾功能(residual renal function,RRF)和心血管事件风险的影响。方法:选取2015年5月至2020年3月池州市人民医院肾内科收治的104例PD患者,随机数表法分成I组和II组,各52例,I组和II组血压控制靶目标分别为<140/90 mmHg、<130/80 mmHg,治疗48周。比较两组治疗前后24 h尿量、残肾尿素清除率(Kt/V)、残肾肌酐清除率(creatinine clearance rate,Ccr)、残肾肾小球滤过率(glomerular filtration rate,GFR)、总Kt/V、总Ccr的变化,并记录心血管事件发生情况。结果:两组治疗48周后24 h尿量、残肾Kt/V、残肾Ccr、残肾GFR、总Kt/V、总Ccr与入组时比较均有明显下降,且II组治疗48周后上述指标均高于I组,差异有统计学意义(P<0.05);II组治疗随访48周内心血管事件发生率5.77%,低于I组的19.23%,差异有统计学意义(P<0.05)。结论:PD患者血压控制靶目标为<130/80 mmHg,有助于保护RRF,提高透析充分性,降低心血管事件发生风险。
关键词: 腹膜透析;血压管理;残余肾功能;心血管事件

Effects of different blood pressure control levels on residual renal function and risk of cardiovascular events in patients with peritoneal dialysis

Authors: 1YANG Mingliu
1 Department of Nephrology, Chizhou People’s Hospital, Chizhou Anhui 247000, China

CorrespondingAuthor: YANG Mingliu Email: 2459776871@qq.com

DOI: 10.3978/j.issn.2095-6959.2021.09.008

Abstract

Objective: To investigate the effects of different blood pressure control levels on residual renal function (RRF) and cardiovascular event risk in patients with peritoneal dialysis (PD). Methods: A total of 104 patients with PD admitted to the Department of Nephrology of Chizhou People’s Hospital from May 2015 to March 2020 were randomly divided into group I and group II, with 52 cases in each group. The targets of blood pressure control in the two groups were <140/90 mmHg and <130/80 mmHg, respectively. The treatment lasted for 48 weeks. The 24 h urine volume, residual renal urea clearance rate (Kt/V), creatinine clearance rate (Ccr), residual renal glomerular filtration rate (GFR), total Kt/V and total Ccr were compared between the two groups before and after treatment, and the occurrence of cardiovascular events was recorded. Results: After 48 weeks of treatment, 24 h urine volume, residual kidney Kt/V, residual kidney Ccr, residual kidney GFR, total Kt/V, total Ccr of the two groups were significantly decreased compared with those before treatment, and the above indexes of group II after 48 weeks of treatment were higher than those of group I, the difference was statistically significant (P<0.05). The incidence of cardiovascular events in group II was 5.77%, which was lower than 19.23% in group I, and the difference was statistically significant (P<0.05). Conclusion: The target of blood pressure control in PD patients is less than 130/80 mmHg, which is helpful to protect RRF, improve dialysis adequacy, and reduce the risk of cardiovascular events.
Keywords: peritoneal dialysis; blood pressure management; residual renal function; cardiovascular events