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Том 10 №1 2008 год - Нефрология и диализ

Взаимосвязь артериальной гипертензии и изменений гемодинамики у больных с хронической почечной недостаточностью, получающих лечение перитонеальным диализом


Новикова Н.А. Гендлин Г.Е. Эттингер О.А. Сторожаков Г.И. Томилина Н.А. Андрусев А.М.

Аннотация: Целями настоящего исследования были определение взаимосвязи между артериальной гипертензией (АГ) и показателями внутрисердечной гемодинамики в условиях изменяющегося интраперитонеального давления при обмене диализирующего раствора и изучение влияния изменений гомеостаза и транспортных характеристик перитонеальной мембраны на степень артериальной гипертензии у больных с терминальной хронической почечной недостаточностью, получающих лечение перитонеальным диализом. Сорока пациентам (23 женщинам и 17 мужчинам) было выполнено суточное мониторирование артериального давления (АД), биохимическое исследование крови и диализата, эхокардиографическое исследование при заполненной и “сухой” брюшной полости, при обмене диализирующего раствора регистрировалось АД на каждой минуте процедуры. Артериальная гипертензия была диагностирована у 95% больных, их которых гипотензивные препараты на момент начала исследования принимали 50%. Была выявлена ассоциация между АГ и снижением функции левого желудочка, усугубляющейся у пациентов с более высокими цифрами АД при наполнении брюшной полости диализирующим раствором. Показано, что целевые значения Kt/V и уровень альбумина крови ³38 г/л являются предикторами достижения лучшего контроля АД.

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Ключевые слова: постоянный амбулаторный перитонеальный диализ, артериальная гипертензия, фракция выброса левого желудочка, интраперитонеальное давление

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