慢性肾脏疾病高血压和高钾血症的认识及治疗策略。

Sang Min Jo
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引用次数: 0

摘要

高血压和钾失衡常见于慢性肾脏疾病(CKD)患者。高血压的发生与多种机制有关。高血压与身体质量指数、饮食盐摄入量和容量过载有关,可以用抗高血压药物治疗。在CKD患者中,控制高血压可以提供重要的效果,可以减缓CKD的进展或减少与肾小球滤过率降低相关的并发症。高钾血症和低钾血症在CKD患者中的患病率相似,分别为15-20%和15-18%,但与低钾血症相比,高钾血症与更高的死亡率相关,需要更加重视治疗和预防。由于钾排泄受损,高钾血症在慢性肾病中很普遍。血清钾水平受肾素-血管紧张素-醛固酮系统抑制剂和利尿剂以及膳食钾摄入量的影响,可通过限制钾饮食、优化肾素-血管紧张素-醛固酮系统抑制剂、聚苯乙烯磺酸钠、帕特罗明和血液透析来控制。这篇综述讨论了缓解和护理CKD患者高血压和高钾血症风险的策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Understanding and Treatment Strategies of Hypertension and Hyperkalemia in Chronic Kidney Disease.

Hypertension and potassium imbalance are commonly observed in chronic kidney disease (CKD) patients. The development of hypertension would be related to several mechanisms. Hypertension is related to body mass index, dietary salt intake, and volume overload and is treated with antihypertensives. In CKD patients, managing hypertension can provide important effects that can slow the progression of CKD or reduce complications associated with reduced glomerular filtration rate. The prevalence of hyperkalemia and hypokalemia in CKD patients was similar at 15-20% and 15-18%, respectively, but more attention needs to be paid to treating and preventing hyperkalemia, which is related to a higher mortality rate, than hypokalemia. Hyperkalemia is prevalent in CKD due to impaired potassium excretion. Serum potassium level is affected by renin-angiotensin-aldosterone system inhibitors and diuretics and dietary potassium intake and can be managed by potassium restriction dietary, optimized renin-angiotensin-aldosterone system inhibitor, sodium polystyrene sulfonate, patiromer, and hemodialysis. This review discussed strategies to mitigate and care for the risk of hypertension and hyperkalemia in CKD patients.

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Electrolyte and Blood Pressure
Electrolyte and Blood Pressure Medicine-Internal Medicine
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