透析中高血压发病率为5％～15％,与透析患者预后密切相关.透析中高血压发病机制、治疗策略目前尚不明确,可能的发病机制包括细胞外液容量负荷、心输血量增加、电解质紊乱(尤其是钠离子)、肾素—血管紧张素系统激活、交感神经系统过度活跃及内皮细胞功能不全等.主要治疗方案包括控制容量、减少钠的摄入、降低交感神经系统活性及减少内皮素的水平等.%Intradialytic hypertension, defined as an increase in blood pressure during or immediately after hemodialysis that results in postdialysis hypertension, has long been recognized to complicate the hemodialysis procedure, yet often is largely ignored. The prevalence of this dialytic complication is estimated to be 5% ~ 15% in hemodialysis patients, and it seems to be associated with adverse outcomes. The mechanisms that might be involved in the pathogenesis of intradialytic hypertension include extracellular volume overload, increased cardiac output, changes in electrolyte levels (particularly sodium), activation of the renin-angiotensin-aldosterone system, overactivity of the sympathetic nervous system, and endothelial cell dysfunction. The most important treatment is to offer an adequate sodium and water removal, but reducing sympathetic hyperactivity and reducing endothelin? 1 levels should also be considered.
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