2021_KDIGO临床实践指南-慢性肾脏病患者的血压管理

SUPPLEMENTTOkidneyINTERNATIONALKDIGO2021ClinicalPracticeGuidelinefortheManagementofBloodPressureinChronicKidneyDiseaseVOLUME99|ISSUE3S|MARCH2021www.kidney-international.orgASSOCIATEEDITORSP.TobyCoates,AdelaideTransplantandImmunologyOlivierDevuyst,ZurichPhysiology,Genetics,KidneyCancerTilmanB.Drueke,ParisCKD,Hypertension,NephrolithiasisEDITORNEPHROLOGYDIGESTEDITORJürgenFloege,AachenPierreRonco,ParisChristinaWyatt,NewYorkGlomerulonephritis,CKD-MBDClinicalInvestigationAgnesB.Fogo,NashvilleClinicalandExperimentalRenalPathologySTATISTICIANST.AlpIkizler,NashvilleDEPUTYEDITORVicHasselblad,JacksonvilleDialysis,AcuteKidneyInjury,Nutrition,MetabolismBradRovin,ColumbusZhezhenJin,NewYorkMasaomiNangaku,TokyoTranslationalNephrologyJosephKim,TorontoClinicalandExperimentalCKDYi-JuLi,DurhamandDiabeticKidneyDiseasePASTEDITORSDorotheaNitsch,LondonJaiRadhakrishnan,NewYorkRajasekharRamakrishnan,NewYorkDetlefSchlöndorff,NewYorkEditorKIR,ClinicalStudies,ImagesinNephrology,QaisAl-Awqati,NewYorkMakeYourDiagnosisSauloKlahr,St.LouisKIFELLOWSHIPINTERNSGermaineWong,SydneyThomasE.Andreoli,LittleRockAnnaFrancis,BrisbaneLifeCourseEpidemiology,HealthEconomicsRoscoeR.Robinson,DurhamSethuMadhavan,ColumbusandOnconephrologyEDITORIALBOARDAnupamAgarwal,BirminghamMichelleHladunewich,TorontoMarkOkusa,CharlottesvilleEvrenAzeloglu,NewYorkFanFanHou,GuangzhouJuanOliver,NewYorkSeanBarbour,VancouverPascalHouillier,ParisCristianPattaro,BolzanoJonathanBarratt,LeicesterChi-yuanHsu,SanFranciscoAldoPeixoto,WestHavenDavidBasile,IndianapolisTobiasB.Huber,HamburgMarkPerazella,NewHavenJohnBertram,ClaytonBenjaminHumphreys,St.LouisJanosPeti-Peterdi,LosAngelesPeterBoor,AachenReikoInagi,TokyoMartinPollak,BostonFrankBridoux,PortiersKenarJhaveri,GreatNeckAmbraPozzi,NashvilleKirkCampbell,NewYorkJaapJoles,UtrechtSusanQuaggin,ChicagoDanielCattran,TorontoKamyarKalantar-Zadeh,OrangeW.BrianReeves,SanAntonioRobertoKalil,IowaCityChristosChatziantoniou,ParisHeatherReich,TorontoFrederickKaskel,NewYorkYi-puChen,BeijingGiuseppeRemuzzi,BergamoKrzysztofKiryluk,NewYorkPhilipClayton,AdelaideConnieRhee,OrangeA.RichardKitching,ClaytonStevenCoca,NewYorkMarianoRodriguez,CordobaAnnaKoettgen,FreiburgTerenceCook,LondonPaolaRomagnani,Firenze’JeffreyKopp,BethesdaVivetteDAgati,NewYorkAviRosenberg,BethesdaFarhadDanesh,ChicagoMatthiasKretzler,AnnArborChristianKurts,BonnMichaelRoss,NewYorkJohnDaugirdas,ChicagoDavidLeaf,BostonRobertSafirstein,NewHavenAndrewDavenport,LondonChristopheLegendre,ParisSimoneSanna-Cherchi,NewYorkMarcDeBroe,AntwerpKevinLemley,LosAngelesMarioSchiffer,ErlangenVikasDharnidharka,St.LouisEmmanuelLetavernier,ParisJohannesSchlondorff,BostonKentDoi,TokyoAdeeraLevin,VancouverKaiSchmidt-Ott,NewYorkJieDong,BeijingPhilipK.T.Li,HongKongZhengDong,AugustaStephanSegerer,AarauChristophLicht,TorontoKai-UweEckardt,BerlinKumarSharma,LaJollaJohnLieske,RochesterSomchaiEiam-Ong,BangkokNatalieStaplin,OxfordAdrianLiew,SingaporeMichaelEmmett,DallasKatalinSusztak,PhiladelphiaMelissaLittle,BrisbaneYoshioTerada,NankokuRogerEvans,MelbourneWaiLim,PerthTetsuhiroTanaka,TokyoPieterEvenepoel,LeuvenKathleenLiu,SanFranciscoSydneyC.W.Tang,HongKongRobertFairchild,ClevelandYouhuaLiu,PittsburghSarahFaubel,DenverAlexandreLoupy,ParisRaviThadhani,BostonChristianFaul,BirminghamChristopherLu,DallasPierre-LouisTharaux,ParisFernandoFervenza,RochesterFriedrichLuft,BerlinJoshuaThurman,DenverStevenFishbane,MineolaJohannesMann,MünchenJensTitze,SingaporeDaniloFliser,HomburgPeterJ.Margetts,HamiltonMarcelloTonelli,EdmontonJosephineForbes,BrisbaneGlenMarkowitz,NewYorkHernanTrimarchi,BuenosAiresAlessiaFornoni,MiamiZiadMassy,ParisFrankvanderSande,MaastrichtBarryFreedman,Winston-SalemKunihiroMatsushita,BaltimoreMarcVervloet,AmsterdamMasafumiFukagawa,IseharaMignonMcCulloch,CapeTownMarinaVivarelli,RomeAmitGarg,London,OntarioTimothyW.Meyer,PaloAltoCarstenWagner,ZurichVesnaGarovic,RochesterImariMimura,TokyoAngelaWang,HongKongRichardGlassock,LagunaNiguelJeffreyMiner,St.LouisDonaldWesson,TempleDavidS.Goldfarb,NewYorkMarcusMoeller,AachenJackWetzels,NijmegenMarkHaas,LosAngelesJeremiahMorrissey,St.LouisAdamWhaley-Connell,ColumbiaVolkerHaase,NashvilleRosaMoysés,SãoPauloKeng-ThyeWoo,SingaporeJanHalbritter,LeipzigDavidNikolic-Paterson,ClaytonMotokoYanagita,KyotoPeterC.Harris,RochesterMarinaNoris,RanicaXueqingYu,GuangzhouJohn(Cijiang)He,NewYorkIkechiOkpechi,CapeTownSuzukiYusuke,Tokyowww.kidney-international.orgScopeInquiriesconcerningrecruitment/classifiedadvertisingshouldbeaddressedto:KidneyInternationalisdevotedtokidneyresearch.ItaimstoinformtheUSA/Canada:RobIssler,Tel:+1321-400-8279,E-mail:robert.isslerjr@researcher,theclinicalinvestigator,andthepracticingnephrologistonallaspectstherapeuticsol.com;International:ElsevierClassified,Tel:441425462736,E-mail:ofkidneyresearch.Theseincludethelatestclinicalstudiesonemergingelsevierclassified@elsevier.dbfactory.co.uk.developmentsinnephrologyandthehighestleveloforiginalresearchstudiesinSupplementsclinicalandbasickidneyresearch.ThejournalreflectsthefieldthroughcriticalInquiriesconcerningKidneyInterna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ppendixA.SearchstrategiesTableS1.SearchstrategiesforsystematicreviewtopicsAppendixB.ConcurrencewithInstituteofMedicine(IOM)standardsforguidelinedevelopmentTableS2.Guidelinedevelopmentchecklist–IOMstandardsfordevelopmentoftrustworthyclinicalpracticeguidelinesTableS3.Adaptedsystematicreviewreportingstandardschecklist–IOMstandardsforsystematicreviewsAppendixC.Datasupplement-Summaryoffindings(SoF)tablescitedintheguidelinetextTableS4.GeneralpopulationstudiescomparingauscultatoryversusoscillometricbloodpressuremeasurementdevicesTableS5.AdultswithCKDwithoutdiabetes,low-saltdietversususualornormal-saltdietTableS6.Adultswithtype1diabetesandCKD,low-saltdietversusnormal-saltdietTableS7.Adultswithtype2diabetesandCKD,low-saltdietversususualdietTableS8.AdultswithdiabetesandCKDwithmoderatelyincreasedalbuminuria,low-saltdietversusnormal-saltdietTableS9.AdultswithdiabetesandCKDwithseverelyincreasedalbuminuria,low-saltdietversusnormal-saltdietTableS10.AdultswithCKD,anyexercisetoimprovebloodpressureversuscontrol(noexercise/placeboexercise)TableS11.AdultswithCKD,lowbloodpressuretarget(£120mmHg)versusstandardbloodpressuretargetTableS12.AdultswithCKDandincreasedproteinuria/albuminuria,lowbloodpressuretargetversusstandarddiastolicbloodpressuretargetTableS13.AdultswithCKD,lowbloodpressuretargetversusstandardbloodpressuretargetTableS14.AdultswithCKDwithoutdiabetes,lowbloodpressuretargetversusstandardbloodpressuretargetTableS15.AdultswithCKDwithoutdiabetes,ACEiversusplaceboorstandardofcareTableS16.AdultswithCKDwithoutdiabetes,ARBversusplaceboorstandardofcareTableS17.AdultswithCKDwithoutdiabetes,aldosteroneantagonistversusplaceboorstandardcareKidneyInternational(2021)99,S1–S87S3contentswww.kidney-international.orgTableS18.AdultswithCKDwithoutdiabetes,beta-blockersversusRASiTableS19.AdultswithCKDwithoutdiabetes,calciumchannelblockerversusplaceboTableS20.AdultswithCKDwithoutdiabetes,directrenininhibitorsversusRASiTableS21.AdultswithdiabetesandCKD,ACEiversusplaceboorstandardcareTableS22.AdultswithdiabetesandCKD,ARBversusplaceboorstandardcareTableS23.AdultswithdiabetesandCKD,ARBversusACEiTableS24.AdultswithdiabetesandCKD,aldosteroneantagonistsversusplaceboorstandardcareTableS25.AdultswithdiabetesandCKD,beta-blockerversusACEiTableS26.AdultswithdiabetesandCKD,calciumchannelblockerversusplaceboTableS27.AdultswithdiabetesandCKD,diureticsDACEiorARBversusplacebo,standardofcare,ornotreatmentTableS28.AdultswithdiabetesandCKD,aliskirenversusACEiorARB.TableS29.Adultswithtype2diabetesandCKD,aliskirenDACEiorARBversusplaceboDACEiorARBTableS30.AdultswithdiabetesandCKD,calciumchannelblockerversusACEiorARBTableS31.AdultswithCKD,dualRASitherapyversussingleRASitherapyTableS32.Networkmeta-analysisofadultswithCKD,dualRASitherapyversussingleRASitherapyTableS33.Kidneytransplantrecipients,calciumchannelblockersversusplaceboornotreatmentTableS34.Kidneytransplantrecipients,ARBversusplaceboornotreatmentTableS35.Kidneytransplantrecipients,ACEiversusplacebo,notreatment,ornon-antihypertensivetreatmentTableS36.Kidneytransplantrecipients,alpha-blockerversusplaceboornotreatmentTableS37.Kidneytransplantrecipients,beta-blockerversusplaceboornotreatmentTableS38.Kidneytransplantrecipients,mineralocorticoidreceptorantagonistsversusplaceboTableS39.Kidneytransplantrecipients,ACEiorARBversusplacebo,notreatment,orstandardofcareTableS40.ChildrenwithCKD,intensifiedbloodpressurecontrol(MAP<50thpercentile)versusconventionalbloodpressurecontrol(MAP50th–99thpercentile)AppendixD.Datasupplement-AdditionalSoFtablesdevelopedaspartoftheevidencereviewTableS41.CorrelationofbloodpressuremeasurementtechniquesinpatientswithCKDTableS42.AccuracyofbloodpressuremeasurementtechniquesinthegeneralpopulationTableS43.SystematicreviewsofapproachestobloodpressuremeasurementinthegeneralpopulationandassociationswithclinicaloutcomesTableS44.SystematicreviewsofeconomicevaluationsofdifferingapproachestoBPmeasurementinthegeneralpopulationTableS45.AdultswithdiabetesandCKDandhabituallow-saltintake,higherdietarysaltintake(throughNaClsupplement)versusregular-saltintakeTableS46.Adultswithdiabetesandhabitualhigh-saltintake,higherdietarysaltintake(throughNaClsupplement)versusregularsaltintakeTableS47.AdultswithCKD,aerobicexercisetoimprovebloodpressureversuscontrol(noexercise/placebo)TableS48.AdultswithCKD,mixofresistanceandcardiovascularexerciseversuscontrol(noexercise/placebo)TableS49.AdultswithCKDwithoutdiabetes,low-proteinversusnormal-proteindietTableS50.AdultswithCKDwithoutdiabetes,verylow–proteinversusnormal-proteindietTableS51.AdultswithCKD,highbase(non-acidic)fruitandvegetabledietversususualdietwithbicarbonatesupplementTableS52.AdultswithCKDanddiabetes,carbohydrate-restrictedlow-iron–availablepolyphenol-enriched(CR-LIPE)dietversususualdiet(standardprotein–restricteddiet[0.8g/kg/d],isocaloricforidealbodyweightmaintenance)TableS53.AdultswithCKD,intensivedietarycounsellingversususual(health)careS4KidneyInternational(2021)99,S1–S87www.kidney-international.orgcontentsTableS54.AdultswithdiabetesandCKD,lowbloodpressuretargetversusstandar