中国血液净化

中国血液净化 ›› 2023, Vol. 22 ›› Issue (03): 187-192.doi: 10.3969/j.issn.1671-4091.2023.03.007

• 临床研究 • 上一篇    下一篇

慢性肾脏病非透析患者治疗性高血压抵抗患病率的Meta分析

刘丹阳   龚妮容   张广清   施盛莹   林炎虹   杨 聪   艾 军   

  1. 510515 广州，南方医科大学南方医院1肾内科 2医院办公室 3院护理部
  • 收稿日期:2022-08-22 修回日期:2022-12-20 出版日期:2023-03-12 发布日期:2023-03-03
  • 通讯作者: 艾军 E-mail:aij1980@163.com
  • 基金资助:
    国家自然科学基金项目(81770765)；南方医院护理创优-循证护理项目(2020EBNc006)；南方医科大学南方医院院长基金(2020H003)

Prevalence of apparent treatment resistant hypertension in non-dialysis patients with chronic kidney disease: a meta-analysis

LIU Dan-yang, GONG Ni-rong, ZHANG Guang-qing, SHI Sheng-ying, LIN Yan-hong, YANG Cong, AI Jun   

  1. 1Department of Nephrology, 2Administrative Office, and 3Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
  • Received:2022-08-22 Revised:2022-12-20 Online:2023-03-12 Published:2023-03-03
  • Contact: 510515 广州，南方医科大学南方医院1肾内科 E-mail:aij1980@163.com

PDF

50

摘要： 目的 系统评价慢性肾脏病(chronic kidney disease,CKD)非透析患者治疗性高血压抵抗(apparent treatment resistant hypertension,aTRH)的患病率。 方法 检索中英文数据库中有关CKD非透析患者aTRH患病率的观察性研究，aTRH定义为参考美国心脏协会(American Heart Association,AHA)所提出的AHA-1及AHA-2，应用Stata15.0软件对不同aTRH定义下的CKD总体和分期的患病率进行荟萃(Meta)分析。 结果 共纳入14项研究，CKD患者aTRH的总患病率27.1%(ES=0.271,95% CI: 0.220～0.321,P＜0.001)；AHA-1定义下，CKD 1～5期患者中aTRH患病率为20.6%(ES=0.206,95% CI:0.105～0.307,P＜0.001)，CKD 3～5期患者中aTRH的患病率为29.5%(ES=0.295,95% CI:0.224～0.366,P＜0.001)；AHA-2定义下，CKD 1～5期患者的aTRH患病率为30.4%(ES=0.304,95% CI:0.178～0.430,P＜0.001)；CKD的aTRH患病率均呈现出随着肾小球滤过率的下降而不断升高的趋势。 结论 CKD非透析患者aTRH患病率较高，并随肾损伤的进展逐步上升，应加强对慢性肾脏病患者aTRH的关注。

关键词: 慢性肾脏病, 高血压抵抗

Abstract: Objective  To systematically review the prevalence of apparent treatment resistant hypertension (aTRH) in non-dialysis patients with chronic kidney disease (CKD).  Methods  Chinese and English databases were searched for observational studies on the prevalence of aTRH in non-dialysis patients with CKD. According to the American Heart Association (AHA) criteria, aTRH was defined as AHA-1 and AHA-2. Stata 15.0 was used for the meta-analysis of overall and staged prevalence of CKD under different aTRH definitions.  Results A total of 14 studies were included. The overall prevalence of aTRH in CKD patients was 27.1% (ES=0.271, 95% CI: 0.220~0.321, P＜0.001). Under AHA-1 definition, the prevalence of aTRH in CKD1-5 patients was 20.6% (ES=0.206, 95% CI: 0.105~0.307, P＜0.001), and the prevalence of aTRH in CKD3-5 patients was 29.5% (ES=0.295, 95% CI: 0.224~0.366, P＜0.001). Under AHA-2 definition, the prevalence of aTRH in CKD1-5 patients was 30.4% (ES=0.304, 95% CI: 0.178~0.430, P＜0.001). The prevalence of aTRH in CKD patients increased with the decrease of glomerular filtration rate in all original studies.  Conclusion The prevalence of aTRH in non-dialysis CKD patients is high and increases with the progression of renal injury. More attention should be paid to aTRH in CKD patients. 

Key words: Chronic kidney disease, Resistant hypertension

中图分类号: