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为探讨终末期肾衰（ＥＳＲＦ）高血压病因及合理治疗方案，对１９９５年６月至１９９６年２月收治的ＥＳＲＦ１５１例进行临床研究，其中高血压１３１例（８７％），超滤达到干体重后，血压降至正常８３例（６３％）。高血压组血浆肾素活性（ＰＲＡ）、血管紧张素Ⅱ和甲状旁腺素（ＰＴＨ）均显著高于血压正常组。透析后高血压４８例，单用血管紧张素转换酶抑制剂（ＡＣＥＩ），血压降至正常２３例（４８％），先后加用钙通道阻滞剂（ＣＣＢ）和可乐定，血压降至正常分别为１８例和５例。３种抗高血压药联合使用时，仍有高血压２例，改用腹膜透析后血压正常。以上结果提示，ＥＳＲＦ高血压的发生与容量负荷过重、肾素－血管紧张素系统（ＲＡＳ）过度活跃以及继发性甲旁亢有关。合理的治疗方案可能包括：①达到及维持干体重，适当控制透析间期体重；②抗高血压治疗首选ＡＣＥＩ，必要时加用ＣＣＢ和中枢性抗高血压药；③在３种药物联合治疗无效时，改变透析方式。
To investigate the etiopathogenisis and reasonable treatment of ESRF, 151 cases of ESRF were enrolled from June 1995 to February 1996, including 131 cases of hypertension (87%), ultrafiltration After the blood pressure dropped to normal 83 cases (63%). Plasma renin activity (PRA), angiotensin Ⅱ and parathyroid hormone (PTH) in hypertension group were significantly higher than those in normal blood pressure group. 48 cases of post-dialysis hypertension, angiotensin converting enzyme inhibitor alone (ACEI), blood pressure decreased to normal in 23 cases (48%), followed by calcium channel blockers (CCB) and clonidine, blood pressure dropped to normal Respectively, 18 cases and 5 cases. 3 kinds of antihypertensive drugs used in combination, there are still 2 cases of hypertension, switch to normal blood pressure after peritoneal dialysis. The above results suggest that the occurrence of ESRF hypertension is associated with overloaded capacity, renin-angiotensin system (RAS) hyperactivity, and secondary hyperparathyroidism. Reasonable treatment options may include: ① achieve and maintain dry weight, proper control of dialysis interval weight; ② antihypertensive treatment preferred ACEI, if necessary, add CCB and central antihypertensive drugs; ③ combination of three drugs ineffective When changing the dialysis method.