Therapy of resistant hypertension in patients with chronic kidney disease complications of anemia in hemodialysis: a case report

Yenry Sumarlim, Emilia Gan, Desantika Wuryana, M. H. Pristantiningtyas, Herya Putra Dharma, Muhammad Muchlis, Jainuri Erik Pratama, A. P. Setiadi, M. Gondokesumo
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Abstract

Chronic Kidney Disease (CKD) is closely related to hypertension. Increasing the severity of CKD is associated with more difficult blood pressure control. Appropriate therapeutic management is needed to prevent complications due to uncontrolled hypertension. We report the case of a 78-year-old female patient with a diagnosis of hypertension and end-stage CKD with a history of undergoing hemodialysis for 4 years. The patient has been taking antihypertensive drugs such as Angiotensin Receptor Blockers, Calcium Channel Blockers and Diuretics. However, the administration of three antihypertensive drugs still could not help achieve the expected blood pressure target where the systolic blood pressure was still above 160 mmHg. The patient also has anemia as a common complication of chronic kidney disease. Appropriate management of therapy with fourth-line therapy and hemoglobin repair is necessary to achieve improved clinical outcomes and reduce renal worsening.
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慢性肾脏病患者血液透析中贫血并发症的耐药性高血压治疗:病例报告
慢性肾脏病(CKD)与高血压密切相关。慢性肾脏病的严重程度越高,血压控制就越困难。需要采取适当的治疗管理,以防止因高血压失控而引发并发症。我们报告了一例 78 岁女性患者的病例,她被诊断为高血压和终末期 CKD,并有 4 年的血液透析史。患者一直在服用血管紧张素受体阻滞剂、钙通道阻滞剂和利尿剂等降压药物。然而,服用三种降压药仍无法帮助患者达到预期的血压目标,收缩压仍高于 160 毫米汞柱。患者还患有贫血,这是慢性肾病的常见并发症。为了改善临床疗效,减少肾功能恶化,有必要使用四线疗法和血红蛋白修复疗法进行适当的治疗管理。
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