arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2022-28-6-627-640arthyper-2239Research ArticleОбзоры и лекцииReviewВедение артериальной гипертензии у больных с хронической болезнью почек на гемодиализеManagement of arterial hypertension in patients with chronic kidney disease on hemodialysishttps://orcid.org/0000-0002-2733-4524БатюшинМ. М.BatiushinM. M.

Батюшин Михаил Михайлович — доктор медицинских наук, профессор, профессор кафедры внутренних болезней № 2, заведующий нефрологическим отделением 

Нахичеванский пер., д. 29, г. Ростов-на-Дону, 344022

Mikhail M. Batiushin, MD, Professor, Professor of the Department of Internal Diseases No. 2, Head of the Nephrology Department

29 Nakhichevansky lane, Rostov-on-Don, 344022

batjushin-m@rambler.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Ростовский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияRostov State Medical UniversityRussian Federation202208082022286627640Copyright © Батюшин М.М., 20232023Батюшин М.М.Batiushin M.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/2239

Статья представляет собой обзор сведений о ведении артериальной гипертензии на гемодиализе. Данная проблема является актуальной ввиду слабой проработанности. Вместе с тем, распространенность артериальной гипертензии на гемодиализе 91,4%. В статье рассматриваются опросы, касающиеся критериев определения артериальной гипертензии на гемодиализе и методологических подходов к ее регистрации, целевых значений артериального давления в процессе терапии. Также рассматривается понятие интрадиализной гипертензии, вопросы патогенеза артериальной гипертензии на гемодиализе. Автором представлены подходы к немедикаментозной терапии и лекарственному лечению больных с артериальной гипертензией на гемодиализе. В частности рассмотрены подходы к контролю натрия и волемического статуса в рамках пациент-зависимых и аппарат-зависимых технологий. Представлены данные по эффективности применения отдельных классов антигипертензивных препаратов, в частности, рассмотрены диуретики, блокаторы ренин-ангиотензин-альдостероновой системы, бета-адреноблокаторы, антагонисты кальциевых каналов, минералокортикоидных рецепторов. В статье отражены потребности современной клинической практики в проведении исследований доказательной медицины и определены критические точки направленности таких исследований.   

The article is a review of information about the management of arterial hypertension (AH) on hemodialysis. This problem is relevant due to poor elaboration. At the same time, the prevalence of AH on hemodialysis is 91,4 %. The article discusses surveys concerning criteria for determining AH on hemodialysis and methodological approaches to its registration, target values of blood pressure during therapy. The concept of intradialysis hypertension, issues of the pathogenesis of AH on hemodialysis are also considered. The author presents approaches to nondrug therapy and drug treatment of patients with AH on hemodialysis. In particular, approaches to the control of sodium and volemic status within the framework of patient-dependent and apparatus-dependent technologies are considered. Data on the effectiveness of the use of certain classes of antihypertensive drugs are presented, in particular, diuretics, blockers of the renin-angiotensin-aldosterone system, beta-blockers, calcium channel antagonists, mineralocorticoid receptors are considered. The article reflects the needs of modern clinical practice in conducting evidence-based medicine research and identifies the critical points of orientation of such research.

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The authors declare that there are no conflicts of interest present.