论文部分内容阅读
目的观察饮食限盐对合并高血压的非透析慢性肾脏病(chronic kidney disease,CKD)患者血压的影响。方法收集2006年6~12月于北京大学第一医院肾内科就诊的26例24h尿钠排泄量(24h UNa)大于100mmol/d的CKD合并高血压患者,给予饮食指导,观察8周后血压、血及尿电解质、肾功能及尿蛋白的变化。观察期间患者降压药维持不变,观察结束时24h UNa较限钠前下降≤10%认为限钠失败。结果18例患者限钠成功,24hUNa由(243.8±71.2)mmol/d下降至(135.0±49.1)mmol/d(P<0.01)。与治疗前相比,其收缩压平均下降11.4mm Hg(P<0.01)(1mm Hg=0.133kPa);舒张压平均下降6.8mm Hg(P=0.008);平均动脉压下降8.4mm Hg(P=0.001);尿蛋白中位数由1.17g/d降至0.94g/d。在8例限钠失败患者中,观察期开始及结束时的24h UNa分别为(166.4±41.4)mmol/d和(203.3±67.3)mmol/d(P=0.069),其收缩压、舒张压、平均动脉血压和尿蛋白均无明显变化(P>0.05)。结论饮食限盐可有益于CKD合并高血压患者的降压治疗,并可能有助于减少尿蛋白。
Objective To observe the effects of dietary salt restriction on blood pressure in non-dialysis chronic kidney disease (CKD) patients with hypertension. Methods Twenty-six patients with hypertension and CKD with 24h UNa of more than 100 mmol / d at the Department of Nephrology, Peking University First Hospital from June 2006 to December 2006 were enrolled in this study. Dietary guidance was given. Blood pressure, Blood and urine electrolytes, renal function and urinary protein changes. During the observation period, the antihypertensive drugs remained unchanged. At the end of observation, 24h UNa decreased more than or equal to 10% before sodium limitation and sodium limitation failed. Results 18 cases of patients with limited sodium success, 24hUNa decreased from (243.8 ± 71.2) mmol / d to (135.0 ± 49.1) mmol / d (P <0.01). Systolic blood pressure decreased by 11.4 mm Hg (P <0.01) (1 mm Hg = 0.133 kPa), mean diastolic blood pressure decreased by 6.8 mm Hg (P = 0.008), mean arterial pressure decreased by 8.4 mm Hg 0.001); urinary protein median decreased from 1.17g / d to 0.94g / d. In 8 patients with limited sodium failure, the UNa at the beginning and the end of the observation period were (166.4 ± 41.4) mmol / d and (203.3 ± 67.3) mmol / d (P = 0.069), respectively, with systolic, diastolic, Mean arterial pressure and urine protein had no significant changes (P> 0.05). Conclusion Dietary salt restriction may be beneficial to the antihypertensive treatment in CKD patients with hypertension and may be helpful to reduce urinary protein.