普遍血液透析患者甲状旁腺功能亢进与析出内高血压之间的关系

Khaled Gouda, Saeed Abdelwahaab Saeed, Amira Mahmoud Mahmoud, Mohamed Ali Ezzat
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摘要

背景:80%以上接受血液透析的患者患有甲状旁腺功能亢进症,这是慢性肾脏病(CKD)的常见并发症,也是一个令人担忧的主要问题;因为CKD会增加心血管风险,降低生活质量。慢性肾脏病的早期阶段是导致继发性甲状旁腺功能亢进的病理生理机制的起始阶段,其加剧程度与肾功能的丧失成正比。研究目的调查流行性血液透析患者中甲状旁腺功能亢进与透析内高血压之间的关系。患者和方法我们在达卡利亚省医院共招募了 70 名患有甲状旁腺功能亢进症(iPTH>300)的流行性血液透析患者(年龄在 18 岁以上 60 岁以下),对他们进行了多中心横断面研究。我们的研究设计招募了这些患者,并根据他们罹患血液透析内高血压的情况将他们分为第1组:血液透析内高血压患者(10人)和第2组:无血液透析内高血压患者(60人),并对他们进行了详细的病史、检查和实验室检查。结果肾内高血压患者体重增加的平均值(1.9 ± 0.9 kg)高于非肾内高血压患者(0.9 ± 0.3 kg),两者之间的差异有统计学意义(P=0.025)。我们还注意到,两组患者的透析内血压测量结果差异显著(P<0.05),每组患者透析后与透析前收缩压监测结果差异显著(P<0.001)。血液透析内高血压患者的平均血红蛋白水平较低,两组之间的差异有统计学意义(P=0.011)。结论我们的研究表明,在流行性血液透析患者中,析出内高血压和甲状旁腺功能亢进的患病率之间没有统计学意义上的显著相关性。
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Association between Hyperparathyroidism and Intradialytic Hypertension in Prevalent Hemodialysis Patients
Background: Over 80% of patients receiving hemodialysis have hyperparathyroidism, a common complication of chronic kidney disease (CKD) that is a major concern; given the increased cardiovascular risk and declining quality of life associated with CKD. Early stages of CKD are when the pathophysiologic mechanisms causing secondary hyperparathyroidism begin, and they intensify in direct proportion to the loss of renal function. Objective: Investigate the association between hyperparathyroidism and intradialytic hypertension in prevalent hemodialysis patients. Patients and Methods: We conducted a multicenter cross-sectional study at a total of 70 prevalent hemodialysis patients with hyperparathyroidism (iPTH>300), aged more than 18 years old and less than 60 years at El-Dakahlia Governorate hospitals. They have been recruited to our study design and assigned according to developing intradialytic hypertension into group 1: patients with intradialytic hypertension (n=10) and group 2: patients without intradialytic hypertension (n=60) and they were subjected to detailed medical history, examinations, and laboratory investigations. Results: The patients with intradialytic hypertension had higher mean of weight gain (1.9 ± 0.9 kg) than patients without (0.9 ± 0.3 kg) with statistically significant differences between them as p=0.025. We also noted a statistically significant difference between both groups as regards the intradialytic blood pressure measurements (p<0.05) with a difference between post versus pre dialytic systolic blood pressure monitoring in the patients within each group (p<0.001). Lower mean of hemoglobin level has been detected in the patients with intradialytic hypertension with statistically significant differences between both groups as p=0.011. Conclusion: Our study demonstrated that no statistically significant correlation noted between the prevalence of intradialytic hypertension and hyperparathyroidism among prevalent hemodialysis patients.
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