盐排泄依赖的肾脏病高血压治疗进展

Sodium excretion dependent anti hypertension therapy

高血压患者逐年增多,而多达1/2的高血压人群存在盐敏感性。本综述分析近年来通过盐排泄依赖的肾病高血压的相关研究,探寻盐排泄和高血压之间的关联,以期为临床治疗高血压探索新的思路和方法。利用万方数据、PubMed中英文数据库,中文以“高血压”“钠”和“肾”为关键词,检索2015-01-2019-05相关文献,共检索出合格文献21篇,剔除文献18篇,纳入文献3篇;英文以“Sodium excretion”“hypertension”“chronic kidney disease”为关键词,检索2015-01-2019-05相关文献,相关文献101篇。纳入标准:符合检索内容的临床研究、文献、著作。剔除标准:(1)综述类文献;(2)研究资料缺失或质量较差。最终纳入文献59篇。结果表明,终末期肾病中容量负荷增加为常见的加重高血压的因素,与盐摄入量增高有关。因此,肾脏病高血压患者中排盐相关性降压治疗十分重要。目前排盐治疗主要是通过增加肾脏和肠道盐排泄为主,为临床治疗高血压病提供了重要思路。

There is a tendency of growing population of hypertensive patients,and up to 50% of the hypertensive populations have salt sensitivity.This review analyzes the recent studies on renal hypertension treated with salt excretion,and explores the relationship between salt excretion and hypertension.Using Wanfang data and PubMed to search Chinese and English literatures individually,Chinese with"hypertension""sodium"and"kidney"as keywords,search 2015-01-2019-05 related literatures,a total of 21 qualified documents were retrieved.18 articles were excluded for irrelevant and 3 articles were included.In English",Sodium excretion""hypertension"and"chronic kidney disease"were used to search the related documents of 2015-01-2019-05,and 101 related articles.Inclusion criteria:clinical studies,literature,and works that match the search.Exclusion criteria:(1)review literature;(2)lack of research data or poor quality.Finally,59 articles were included in the literature.The results showed that increased volume load in end-stage renal disease is a common factor that aggravated hypertension and was associated with increased salt intake.Therefore,salt-related antihypertensive treatment is very important in patients with kidney disease and hypertension.At present,salt-discharging treatment is mainly based on increasing renal and intestinal salt excretion,which provides an important idea for clinical treatment of hypertension.