臨牀透析 Vol.17 No.10(2-2)


特集名 透析患者における心・血管系合併症と対策
題名 透析者における心・血管系合併症 (2) 高血圧
発刊年月 2001年 09月
著者 草野 英二 自治医科大学腎臓内科
【 要旨 】 透析患者の高血圧は心・血管系合併症の発症,また死亡に密接に関与するため,その管理,治療がきわめて重要である.米国では,短時間透析が一時もてはやされたが,高血圧の調節に難点があり,最近ではむしろ長時間透析が高血圧の調節や生存率の改善に有効としている.透析患者の血圧と心・血管系合併症による死亡率に関しては,透析後の血圧は高すぎても低すぎても良くないという.dry weightの設定,降圧薬の使用,心・血管系合併症による死亡率の相互関連に対して,evidenceの集積と対策が大いに期待される.糖尿病性腎症透析患者の降圧薬治療は合併症に注意する.
Theme Management of Cardio-vascular Complication in Hemodialysis Patient
Title Management and treatment for the hypertension in the dialysis patients
Author Eiji Kusano Division of Nephrology, Internal Medicine, Jichi Medical School
[ Summary ] Management and treatment for the hypertension are very important for dialysispatients, since the hypertension is closely related to the occurance of cardiovascular complications and death rates. Although short time dialysis was very popular in USA, its use presented problems in controlling hypertension. Recently, long term dialysis has been shown to be effective for controlling hypertension and making improvements in survivalrates. Concerning the relationship between control of hypertension and death rates by cardiovascular complications, both excessively high or low blood pressure, after dialysis sessions seems to be undesirable. The accumulated evidence seems to support the interrelation of dry weight figures, use of antihypertensive drugs and death rates, due to cardiovascular complications. In diabetic dialysis paptients, we should pay attention to complications related to diabetes mellitus for the administaration of antihypertensive drugs.
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