高血压合并慢性肾脏病患者的降压目标之争议

Controversies over the targets of controlling blood pressure in hypertensive patients with chronic kidney disease

慢性肾脏疾病(CKD)发病率不断增加,已成为全球性重大公共卫生问题。高血压与CKD二者可互为因果,常常并存,控制血压是CKD治疗中核心任务之一。近10年来,针对CKD患者的血压管理,尽管有较多大型临床研究为指南修订与更新提供循证医学依据,CKD患者的降压目标仍存有争议。个性化和循证管理是实现有效控制血压、减缓CKD进展的关键。鉴于此,本文将对高血压合并CKD的流行病学现状,以及CKD患者降压目标相关进展进行综述。

The increasing incidence of chronic kidney disease(CKD)has become a major global public health problem.Hypertension and CKD can cause and effect each other and often coexist.Controlling blood pressure is one of the core tasks in the treatment of CKD.Over the past 10 years,many large clinical studies have provided evidencebased medical evidence for the updating and revision of hypertension management guidelines,but there remains controversies in targets of blood pressure in hypertensive patients with CKD. Personalizedand evidence-based management is the keyto achieve effective control of blood pressure andslow the progression of CKD. This review will summarythe epidemiological status of hypertensive patientswith CKD and the progress related to the targetsof controlling blood pressure in CKD.