Tom 7, Nr 4 (2021)
Artykuł przeglądowy
Opublikowany online: 2021-12-30
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Terapia nadciśnienia tętniczego u chorych z przewlekłą chorobą nerek leczonych dializami. Informacje praktyczne dla lekarzy niespecjalizujących się w nefrologii
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Nadciśnienie Tętnicze w Praktyce 2021;7(4):251-258.
Streszczenie
U chorych z niewydolnością nerek wymagającą leczenia nerkozastępczego dializami występuje najwyższy wskaźnik współchorobowości, co stanowi o wielkim wyzwaniu dla współczesnej medycyny, jakim jest opieka nad pacjentami w tej grupie. Nadciśnienie tętnicze (NT) występuje u większości tych chorych, a jego leczenie jest znacznie utrudnione przez wiele czynników, w tym niewielką liczbę danych medycznych zgodnych z medycyną opartą na dowodach (EBM). Za najistotniejsze w rozwoju NT u chorych dializowanych uznaje się przewodnienie, a jego kontrola stanowi warunek optymalnego leczenia NT.
Stosowanie leków obniżających ciśnienie tętnicze, niezależnie od wysokości ciśnienia tętniczego, przynosi korzyści chorym dializowanym, o ile dobrze tolerują taką terapię. Wybór leku jest trudny z powodu słabej jakości danych z badań klinicznych, jednak dostępne informacje wskazują, że leki z grupy beta-blokerów i antagonistów aldosteronu przynoszą najwięcej korzyści chorym dializowanym.
Słowa kluczowe: nadciśnienie tętniczedializyhemodializyleczenie
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