Ведение артериальной гипертензии у больных с хронической болезнью почек на гемодиализе
https://doi.org/10.18705/1607-419X-2022-28-6-627-640
Аннотация
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.
Об авторе
М. М. Батюшин
Федеральное государственное бюджетное
образовательное учреждение высшего образования
«Ростовский государственный медицинский университет»
Министерства здравоохранения Российской Федерации
Россия
Россия
Батюшин Михаил Михайлович — доктор медицинских наук, профессор, профессор кафедры внутренних болезней № 2, заведующий нефрологическим отделением
Нахичеванский пер., д. 29, г. Ростов-на-Дону, 344022
Список литературы
1. Doulton TWR, Swift PA, MurtazaA, Dasgupta I. Uncertainties in BP management in dialysis patients. Semin Dial. 2020;33(3): 223–235. doi:10.1111/sdi.12880
2. Tsikliras N, Georgianos PI, Vaios V, Minasidis E, Anagnostara A, Chatzidimitriou C et al. Prevalence and control of hypertension among patients on haemodialysis. Eur J Clin Invest. 2020; 50(10):e13292. doi:10.1111/eci.13292
3. K/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. Am J Kidney Dis. 2004;43(5 Suppl 1):S 1–S 290.
4. Sarafidis PA, Persu A, Agarwal R, Burnier M, de Leeuw P, Ferro C et al. Hypertension in dialysis patients: a consensus document by the European Renal and Cardiovascular Medicine (EURECA-m) working group of the European Renal Association — European Dialysis and Transplant Association (ERA-EDTA) and the Hypertension and the Kidney working group of the European Society of Hypertension (ESH). Nephrol Dial Transplant. 2017;32(4):620–640. doi:10.1097/HJH.0000000000001283
5. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M et al. 2018 Practice Guidelines for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. Blood Press. 2018;27(6):314–340. doi:10.1080/08037051.2018.1527177
6. Кобалава Ж. Д., Конради А. О., Недогода С. В., Шляхто Е. В., Арутюнов Г. П., Баранова Е. И. и др. Артериальная гипертензия у взрослых. Клинические рекомендации 2020. Российский кардиологический журнал. 2020;25(3):3786. doi.org/10.15829/1560-4071-2020-3-3786
7. Клинические рекомендации. Хроническая болезнь почек (ХБП). Нефрология. 2021;25(5):10–82.
8. Tsai WC, Wu HY, Peng YS, Yang JY, Chen HY, Chiu YL et al. Association of intensive blood pressure control and kidney disease progression in nondiabetic patients with chronic kidney disease: a systematic review and meta-analysis. JAMA Intern Med. 2017;177(6):792–799.
9. Lv J, Ehteshami P, Sarnak MJ, Tighiouart H, Jun M, Ninomiya T et al. Effects of intensive blood pressure lowering on the progression of chronic kidney disease: a systematic review and meta-analysis. CMAJ. 2013;185(11):949–957.
10. KDIGO 2021 clinical practice guideline for the management of blood pressure in chronic kidney disease. Kidney Int. 2021;99(3S): S 1–S 87. doi:10.1016/j.kint.2020.11.003
11. Robinson BM, Tong L, Zhang J, Wolfe RA, Goodkin DA, Greenwood RN et al. Blood pressure levels and mortality risk among hemodialysis patients in the dialysis outcomes and practice patterns study. Kidney Int. 2012;82(5):570–580. doi:10.1038/ki.2012.136
12. Bansal N, McCulloch CE, Lin F, Alper A, Anderson AH, Cuevas M et al. Blood pressure and risk of cardiovascular events in patients on chronic hemodialysis: the CRIC study (Chronic Renal Insufficiency Cohort). Hypertension. 2017;70(2):435–443. doi:10.1161/HYPERTENSIONAHA.117.09091
13. Miskulin DC, Gassman J, Schrader R, Gul A, Jhamb M, Ploth DW et al. BP in dialysis: results of a pilot study. J Am Soc Nephrol. 2018;29(1):307–316. doi:10.1681/ASN.2017020135
14. Banerjee D, Winocour P, Chowdhury TA, De P, Wahba M, Montero R et al. Association of British Clinical Diabetologists and the Renal Association. management of hypertension and reninangiotensin-aldosterone system blockade in adults with diabetic kidney disease: Association of British Clinical Diabetologists and the Renal Association UK guideline update 2021. BMC Nephrol. 2022;23(1):9. doi:10.1186/s12882-021-02587-5
15. Pappaccogli M, Labriola L, Van der Niepen P, Pruijm M, Vogt L, Halimi JM et al. Is blood pressure measured correctly in dialysis centres? Physicians’ and patients’ views. Nephrol Dial Transplant. 2019;34(9):1612–1615. doi:10.1093/ndt/gfz125
16. Port FK, Hulbert-Shearon TE, Wolfe RA, Bloembergen WE, Golper TA, Agodoa LY et al. Predialysis blood pressure and mortality risk in a national sample of maintenance hemodialysis patients. Am J Kidney Dis. 1999;33(3):507–517. doi:10.1016/s02726386(99)70188-5
17. Stidley CA, Hunt WC, Tentori F, Schmidt D, Rohrscheib M, Paine S et al. Changing relationship of blood pressure with mortality over time among hemodialysis patients. J Am Soc Nephrol. 2006; 17(2):513–520. doi:10.1681/ASN.2004110921
18. Agarwal R. Blood pressure and mortality among hemodialysis patients. Hypertension. 2010;55(3):762–768. doi:10.1161/HYPERTENSIONAHA.109.144899
19. Agarwal R, Brim NJ, Mahenthiran J, Andersen MJ, Saha C. Out-ofhemodialysis-unit blood pressure is a superior determinant of left ventricular hypertrophy. Hypertension. 2006;47(1):62–68. doi:10.1161/01.HYP.0000196279.29758.f4
20. DoultonTWR,SwiftPA,MurtazaA,Dasgupta I. Uncertainties in BP management in dialysis patients. Semin Dial. 2020;33(3): 223–235. doi:10.1111/sdi.12880
21. Van Buren P, Kim C, Toto R, Inrig J. The prevalence of persistent intradialytic hypertension in a hemodialysis population with extended follow-up. Int J Artif Organs. 2012;35(12):1031–1038.
22. Park J, Rhee CM, Sim JJ, Kim YL, Ricks J, Streja E et al. A comparative effectiveness research study of the change in blood pressure during hemodialysis treatment and survival. Kidney Int. 2013;84(4):795–802. doi:10.1038/ki.2013.237
23. Inrig JK, Oddone EZ, Hasselblad V, Gillespie B, Patel UD, Reddan D et al. Association of intradialytic blood pressure changes with hospitalization and mortality rates in prevalent ESRD patients. Kidney Int. 2007;71(5):454–461. doi:10.1038/sj.ki.5002077
24. Inrig J, Patel U, Toto R, Szczech L. Association of blood pressure increases during hemodialysis with 2-year mortality in incident hemodialysis patients: a secondary analysis of the Dialysis Morbidity and Mortality Wave 2 Study. Am J Kidney Dis. 2009;54(5):881–890. doi:10.1053/j.ajkd.2009.05.012
25. Zoccali C, Moissl U, Chazot C, Mallamaci F, Tripepi G, Arkossy O et al. Chronic fluid overload and mortality in ESRD. J Am Soc Nephrol. 2017;28(8):2491–2497. doi:10.1681/ASN.2016121341
26. Mc Causland FR, Waikar SS, Brunelli SM. Increased dietary sodium is independently associated with greater mortality among prevalent hemodialysis patients. Kidney Int. 2012;82(2):204–211. doi:10.1038/ki.2012.42
27. Kauric-Klein Z. Sodium knowledge, beliefs, and behaviors in patients on chronic hemodialysis. Blood Purif. 2020;49(1–2):25– 32. doi:10.1159/000502678
28. Nicholl DDM, Ahmed SB, Loewen AHS, Hemmelgarn BR, Sola DY, Beecroft JM et al. Declining kidney function increases the prevalence of sleep apnea and nocturnal hypoxia. Chest. 2012;141(6):1422–1430. doi:10.1378/chest.11-1809
29. Unruh ML, Sanders MH, Redline S, Piraino BM, Umans JG, Hammond TC et al. Sleep apnea in patients on conventional thriceweekly hemodialysis: comparison with matched controls from the Sleep Heart Health Study. J Am Soc Nephrol. 2006;17(12):3503–3509. doi:10.1681/ASN.2006060659
30. Abdel-Kader K, Dohar S, Shah N, Jhamb M, Reis SE, Strollo P et al. Resistant hypertension and obstructive sleep apnea in the setting of kidney disease. J Hypertens. 2012;30(5):960–966. doi:10.1097/HJH.0b013e328351d08a
31. Park J, Campese VM. Resistant hypertension and obstructive sleep apnea in end-stage renal disease. J Hypertens. 2012;30(5):880–881. doi:10.1097/HJH.0b013e328352f4c5
32. Tada T, Kusano KF, Ogawa A, Iwasaki J, Sakuragi S, Kusano I et al. The predictors of central and obstructive sleep apnoea in haemodialysis patients. Nephrol Dial Transplant. 2007;22(4):1190–1197. doi:10.1093/ndt/gfl748
33. Lin CH, Lurie RC, Lyons OD. Sleep apnea and chronic kidney disease: a State-of-the-Art Review. Chest. 2020;157(3):673– 685. doi:10.1016/j.chest.2019.09.004
34. Laucyte-Cibulskiene A, Rimsevicius L, Gumbys L, Valanciene D, Miglinas M. Two years of maintenance hemodialysis has a pronounced effect on arterial stiffness progression. Aging Clin Exp Res. 2019;31(2):193–199. doi:10.1007/s40520-018-0971-4
35. Montero D, Haider T, Nägele MP, Barthelmes J, Cantatore S, Sudano I et al. Effects of hemodialysis on blood volume, macroand microvascular function. Microvasc Res. 2020;129:103958. doi:10.1016/j.mvr.2019.103958
36. Claus R, Berliner D, Bavendiek U, Vodovar N, Lichtinghagen R, David S et al. Soluble neprilysin, NT-proBNP, and growth differentiation factor-15 as biomarkers for heart failure in dialysis patients (SONGBIRD). Clin Res Cardiol. 2020;109(8):1035–1047. doi:10.1007/s00392-020-01597-x
37. Bryan PM, Xu X, Dickey DM, Chen Y, Potter LR. Renal hyporesponsiveness to atrial natriuretic peptide in congestive heart failure results from reduced atrial natriuretic peptide receptor concentrations. Am J Physiol Renal Physiol. 2007;292(5): F1636–F1644. doi:10.1152/ajprenal.00418.2006
38. Obineche E, Adeghate E, Chandranath I, Benedict S, Al Gafri L, Adem A. Alterations in atrial natriuretic peptide and its receptors in streptozotocin-induced diabetic rat kidneys. Mol Cell Biochem. 2004;261(1):3–8. doi:10.1023/b:mcbi.0000028732.15710.c2
39. Ichiki T, Jinno A, Tsuji Y. Natriuretic peptide-based novel therapeutics: long journeys of drug developments optimized for disease states. Biology (Basel). 2022;11(6):859. doi:10.3390/biology11060859
40. Agarwal R, Flynn J, Pogue V, Rahman M, Reisin E, Weir MR. Assessment and management of hypertension in patients on dialysis. J Am Soc Nephrol. 2014;25(8):1630–1646. doi:10.1681/ASN.2013060601
41. Georgianos PI, Agarwal R. Blood pressure control in conventional hemodialysis. Semin Dial. 2018;31(6):557–562. doi:10.1111/sdi.12741
42. Cole NI, Swift PA, He FJ, MacGregor GA, Suckling RJ. The effect of dietary salt on blood pressure in individuals receiving chronic dialysis: a systematic review and meta-analysis of randomised controlled trials. J Hum Hypertens. 2019;33(4):319– 326. doi:10.1038/s41371-018-0131-5
43. Mc Causland FR, Waikar SS, Brunelli SM. Increased dietary sodium is independently associated with greater mortality among prevalent hemodialysis patients. Kidney Int. 2012;82(2):204–211. doi:10.1038/ki.2012.42
44. Lambert K, Mullan J, Mansfield K. An integrative review of the methodology and findings regarding dietary adherence in end stage kidney disease. BMC Nephrol. 2017;18(1):318. doi:10.1186/s12882-017-0734-z
45. Santos SF, Peixoto AJ. Revisiting the dialysate sodium prescription as a tool for better blood pressure and interdialytic weight gain management in hemodialysis patients. Clin J Am Soc Nephrol. 2008;3(2):522–530. doi:10.2215/CJN.03360807
46. Locatelli F, Covic A, Chazot C, Leunissen K, Luno J, Yaqoob M. Optimal composition of the dialysate, with emphasis on its influence on blood pressure. Nephrol Dial Transplant. 2004;19(4):785–796. doi:10.1093/ndt/gfh102
47. Dasgupta I, Thomas GN, Clarke J, Sitch A, Martin J, Bieber B et al. Associations between hemodialysis facility practices to manage fluid volume and intradialytic hypotension and patient outcomes. Clin J Am Soc Nephrol. 2019;14(3):385–393. doi:10.2215/CJN.08240718
48. Dunlop JL, Vandal AC, Marshall MR. Low dialysate sodium levels for chronic haemodialysis. Cochrane Database Syst Rev. 2019;1(1):Cd011204. doi:10.1002/14651858.CD011204.pub2
49. Agarwal R, Alborzi P, Satyan S, Light RP. Dry-weight reduction in hypertensive hemodialysis patients (DRIP): a randomized, controlled trial. Hypertension. 2009;53(3):500–507. doi:10.1161/HYPERTENSIONAHA.108.125674
50. Curatola G, Bolignano D, Rastelli S, Caridi G, Tripepi R, Tripepi G et al. Ultrafi tration intensifi ation in hemodialysis patients improves hypertension but increasesAV fi ula complications and cardiovascular events. J Nephrol. 2011;24(4):465–473. doi:10.5301/JN.2011.7735
51. Chazot C, Vo-Van C, Zaoui E, Vanel T, Hurot JM, Lorriaux C et al. Fluid overload correction and cardiac history influence brain natriuretic peptide evolution in incident haemodialysis patients. Nephrol Dial Transplant. 2011;26(8):2630–2634. doi:10.1093/ndt/gfq804
52. Franz M, Pohanka E, Tribl B, Woloszczuk W, Hörl WH. Living on chronic hemodialysis between dryness and fluid overload. Kidney Int Suppl. 1997;59:S 39–S 42. PMID:9185103
53. Davies SJ, Davenport A. The role of bioimpedance and biomarkers in helping to aid clinical decision-making of volume assessments in dialysis patients. Kidney Int. 2014;86(3):489–496. doi:10.1038/ki.2014.207
54. Passauer J, Petrov H, Schleser A, Leicht J, Pucalka K. Evaluation of clinical dry weight assessment in haemodialysis patients using bioimpedance spectroscopy: a cross-sectional study. Nephrol Dial Transplant. 2010;25(2):545–551. doi:10.1093/ndt/gfp517
55. Ok E, Duman S, Asci G, Tumuklu M, Onen Sertoz O, Kayikcioglu M et al. Comparison of 4and 8-h dialysis sessions in thrice-weekly in-centre haemodialysis: a prospective, casecontrolled study. Nephrol Dial Transplant. 2011;26(4):1287–1296. doi:10.1093/ndt/gfq724
56. Chertow GM, Levin NW, Beck GJ, Daugirdas JT, Eggers PW, Kliger AS et al. Long-term effects of frequent incenter hemodialysis. J Am Soc Nephrol. 2016;27(6):1830–1836. doi:10.1681/ASN.2015040426
57. Flythe JE, Kimmel SE, Brunelli SM. Rapid fluid removal during dialysis is associated with cardiovascular morbidity and mortality. Kidney Int. 2011;79(2):250–257. doi:10.1038/ki.2010.383
58. Assimon MM, Wenger JB, Wang L, Flythe JE. Ultrafiltration rate and mortality in maintenance hemodialysis patients. Am J Kidney Dis. 2016;68(6):911–922. doi:10.1053/j.ajkd.2016.06.020
59. MacEwen C, Sutherland S, Daly J, Pugh C, Tarassenko L. Relationship between hypotension and cerebral ischemia during hemodialysis. J Am Soc Nephrol. 2017;28(8):2511–2520. doi:10.1681/ASN.2016060704
60. Seong EY, Zheng Y, Winkelmayer WC, Montez-Rath ME, Chang TI. The relationship between intradialytic hypotension and hospitalized mesenteric ischemia: a Case-Control Study. Clin J Am Soc Nephrol. 2018;13(10):1517–1525. doi:10.2215/CJN.13891217
61. Burton JO, Jefferies HJ, Selby NM, McIntyre CW. Hemodialysis-induced repetitive myocardial injury results in global and segmental reduction in systolic cardiac function. Clin J Am Soc Nephrol. 2009;4(12):1925–1431. doi:10.2215/CJN.04470709
62. Heerspink HJ, Ninomiya T, Zoungas S, de Zeeuw D, Grobbee DE, Jardine MJ et al. Effect of lowering blood pressure on cardiovascular events and mortality in patients on dialysis: a systematic review and meta-analysis of randomised controlled trials. Lancet. 2009;373(9668):1009–1015. doi:10.1016/S0140-6736(09)60212-9
63. Agarwal R, Sinha AD. Cardiovascular protection with antihypertensive drugs in dialysis patients: systematic review and meta-analysis. Hypertension. 2009;53(5):860–866. doi:10.1161/HYPERTENSIONAHA.108.128116
64. St Peter WL, Sozio SM, Shafi T, Ephraim PL, Luly J, McDermott A et al. Patterns in blood pressure medication use in US incident dialysis patients over the first 6 months. BMC Nephrol. 2013;14:249. doi:10.1186/1471-2369-14-249
65. Muntner P, Anderson A, Charleston J, Chen Z, Ford V, Makos G et al. Hypertension awareness, treatment, and control in adults with CKD: results from the Chronic Renal Insufficiency Cohort (CRIC) Study. Am J Kidney Dis. 2009;55(3):441–451. doi:10.1053/j.ajkd.2009.09.014
66. Bragg-Gresham JL, Fissell RB, Mason NA, Bailie GR, Gillespie BW, Wizemann V et al. Diuretic use, residual renal function, and mortality among hemodialysis patients in the Dialysis Outcomes and Practice Pattern Study (DOPPS). Am J Kidney Dis. 2007;49(3):426–431. doi:10.1053/j.ajkd.2006.12.012
67. Sibbel S, Walker AG, Colson C, Tentori F, Brunelli SM, Flythe J. Association of continuation of loop diuretics at hemodialysis initiation with clinical outcomes. Clin J Am Soc Nephrol. 2019;14(1):95–102. doi:10.2215/CJN.05080418
68. Zannad F, Kessler M, Lehert P, Grünfeld JP, Thuilliez C, Leizorovicz A et al. Prevention of cardiovascular events in endstage renal disease: results of a randomized trial of fosinopril and implications for future studies. Kidney Int. 2006;70(7):1318–1324. doi:10.1038/sj.ki.5001657
69. Xydakis D, Papadogiannakis A, Sfakianaki M, Kostakis K, Stylianou K, Petrakis I et al. Residual renal function in hemodialysis patients: the role of Angiotensin-converting enzyme inhibitor in its preservation. ISRN Nephrol. 2012;2013:184527. doi:10.5402/2013/184527
70. Takahashi A, Takase H, Toriyama T, Sugiura T, Kurita Y, Ueda R et al. Candesartan, an angiotensin II type-1 receptor blocker, reduces cardiovascular events in patients on chronic haemodialysis — a randomized study. Nephrol Dial Transplant. 2006;21(9):2507–2512. doi:10.1093/ndt/gfl293
71. Suzuki H, KannoY, Sugahara S, Ikeda N, Shoda J, Takenaka T et al. Effect of angiotensin receptor blockers on cardiovascular events in patients undergoing hemodialysis: an open-label randomized controlled trial. Am J Kidney Dis. 2008;52(3):501–506. doi:10.1053/j.ajkd.2008.04.031
72. Iseki K, Arima H, Kohagura K, Komiya I, Ueda S, Tokuyama K et al. Effects of angiotensin receptor blockade (ARB) on mortality and cardiovascular outcomes in patients with longterm haemodialysis: a randomized controlled trial. Nephrol Dial Transplant. 2013;28(6):1579–1589. doi:10.1093/ndt/gfs590
73. Peters CD, Kjaergaard KD, Jensen JD, Christensen KL, Strandhave C, Tietze IN et al. No significant effect of angiotensin II receptor blockade on intermediate cardiovascular end points in hemodialysis patients. Kidney Int. 2014;86(3):625–637. doi:10.1038/ki.2014.69
74. Wang B, Wang GH, Ding XX, Tang HX, Zheng J, Liu BC et al. Effects of Sacubitril/Valsartan on resistant hypertension and myocardial work in hemodialysis patients. J Clin Hypertens (Greenwich). 2022;24(3):300–308. doi:10.1111/jch.14422
75. Wen Y, Xia Y, Gong Y. Effects and safety of Sacubitril/ Valsartan (SV) on heart function and blood pressure in maintenance hemodialysis (MHD) patients. Am J Transl Res. 2022;14(5):3439–3447. PMID:35702081
76. AgarwalR,SinhaAD,PappasMK,AbrahamTN,TegegneGG. Hypertension in hemodialysis patients treated with atenolol or lisinopril: a randomized controlled trial. Nephrol Dial Transplant. 2014;29(3):672–681. doi:10.1093/ndt/gft515
77. Assimon MM, Brookhart MA, Fine JP, Heiss G, Layton JB, Flythe JE. Acomparative study of carvedilol versus metoprolol initiation and 1-year mortality among individuals receiving maintenance hemodialysis. Am J Kidney Dis. 2018;72(3):337–348. doi:10.1053/j.ajkd.2018.02.350
78. Tella A, Vang W, Ikeri E, Taylor O, Zhang A, Mazanec M et al. β-blocker use and cardiovascular outcomes in hemodialysis: a Systematic Review. Kidney Med. 2022;4(5):100460. doi:10.1016/j.xkme.2022.100460
79. Tepel M, Hopfenmueller W, Scholze A, Maier A, Zidek W. Effect of amlodipine on cardiovascular events in hypertensive haemodialysis patients. Nephrol Dial Transplant. 2008;23(11): 3605–3612. doi:10.1093/ndt/gfn304
80. Reyes-Marín FA, Calzada C, Ballesteros A, Amato D. Comparative study of enalapril vs. losartan on residual renal function preservation in automated peritoneal dialysis. A randomized controlled study. Rev Invest Clin. 2012;64(4):315–21. PMID:232 27581
81. Charytan DM, Himmelfarb J, Ikizler TA, Raj DS, Hsu JY, Landis JR et al. Hemodialysis Novel Therapies Consortium. Safety and cardiovascular efficacy of spironolactone in dialysis-dependent ESRD (SPin-D): a randomized, placebo-controlled, multiple dosage trial. Kidney Int. 2019;95(4):973–982. doi:10.1016/j.kint.2018.08.034
82. Hammer F, Malzahn U, Donhauser J, Betz C, Schneider MP, Grupp C et al. A randomized controlled trial of the effect of spironolactone on left ventricular mass in hemodialysis patients. Kidney Int. 2019;95(4):983–991. doi:10.1016/j.kint.2018.11.025
83. Lin C, Zhang Q, Zhang H, Lin A. Long-term effects of low-dose spironolactone on chronic dialysis patients: a randomized placebo-controlled study. J Clin Hypertens (Greenwich). 2016; 18(2):121–128. doi:10.1016/j.ijrobp.2019.12.001
84. Matsumoto Y, Mori Y, Kageyama S, Arihara K, Sugiyama T, Ohmura H et al. Spironolactone reduces cardiovascular and cerebrovascular morbidity and mortality in hemodialysis patients. J Am Coll Cardiol. 2014;63(6):528–536. doi:10.1016/j.jacc.2013.09.056
85. Ni X, Zhang J, Zhang P, Wu F, Xia M, Ying G et al. Effects of spironolactone on dialysis patients with refractory hypertension: a randomized controlled study. J Clin Hypertens (Greenwich). 2014;16(9):658–63. doi:10.1111/jch.12374
86. Shavit L, Neykin D, Lifschitz M, Slotki I. Effect of eplerenone on blood pressure and the renin-angiotensin-aldosterone system in oligo-anuric chronic hemodialysis patients — a pilot study. Clin Nephrol. 2011;76(5):388–395. doi:10.5414/cn106973
87. Gross E, Rothstein M, Dombek S, Juknis HI. Effect of spironolactone on blood pressure and the renin-angiotensinaldosterone system in oligo-anuric hemodialysis patients. Am J Kidney Dis. 2005;46(1):94–101. doi:10.1053/j.ajkd.2005.03.005
88. Росреестр лекарственных средств. Копия ссылки от 20.07.2022. https://grls.rosminzdrav.ru/grls.aspx?s=&m=mnn.
Дополнительные файлы
Рецензия
Для цитирования:
Батюшин М.М. Ведение артериальной гипертензии у больных с хронической болезнью почек на гемодиализе. Артериальная гипертензия. 2022;28(6):627-640. https://doi.org/10.18705/1607-419X-2022-28-6-627-640
For citation:
Batiushin M.M. Management of arterial hypertension in patients with chronic kidney disease on hemodialysis. "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2022;28(6):627-640. (In Russ.) https://doi.org/10.18705/1607-419X-2022-28-6-627-640
Просмотров:
3557
Послать статью по эл. почте 