肾病患者高血压控制现状与规范化管理策略研究

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Chronic kidney disease (CKD) with hypertension (n=320). Intervention: Standardized multidisciplinary hypertension management protocol (home and ambulatory BP monitoring, individualized KDIGO targets, ACEI/ARB-based pharmacotherapy with CCBs/diuretics/MRAs/SGLT2i, lifestyle modification, and multidisciplinary team follow-up) vs. Pre-intervention baseline status (single-group pre-post comparison). Primary outcome: Blood pressure control rate (office blood pressure < 130/80 mmHg) (p=< 0.001).

Q: What does this research mean for the field?

A standardized multidisciplinary management program significantly increases blood pressure control rates and slows renal function decline in patients with chronic kidney disease and hypertension. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate baseline blood pressure control rates, identify independent risk factors for uncontrolled hypertension, and assess the therapeutic efficacy of a 1-year standardized management program in chronic kidney disease patients.

月 邱; 王少泽; 茹 张

doi:10.37155/2661-4766-0807-29

January 1, 2026临床医学前沿Open Access

肾病患者高血压控制现状与规范化管理策略研究

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Key result

Multidisciplinary hypertension care linked to ~32-point higher BP control in CKD.

P<0.001
n=320

Why the study?

The study aimed to understand the current status of hypertension control in patients with CKD, explore factors influencing blood pressure target achievement, and evaluate the effectiveness of a standardized management model.

Does a 1-year standardized multidisciplinary hypertension management program improve blood pressure control rate and renal function markers in patients with chronic kidney disease and comorbid hypertension?

Key Points

To evaluate baseline blood pressure control rates, identify independent risk factors for uncontrolled hypertension, and assess the therapeutic efficacy of a 1-year standardized management program in chronic kidney disease patients.
Prospective cohort study of 320 patients aged 18 to 75 years with chronic kidney disease and hypertension recruited between January 2022 and June 2024 at a single center.
Conducted a baseline cross-sectional assessment followed by a 1-year standardized intervention featuring home blood pressure monitoring, personalized targets, rational pharmacotherapy, lifestyle intervention, and multidisciplinary care.
At baseline, 26.9% (86/320) of patients reached blood pressure targets; higher CKD stage (OR = 2.14, 95% CI: 1.52–3.01), poor medication adherence (OR = 3.27, 95% CI: 2.18–4.91), irregular blood pressure monitoring (OR = 2.56, 95% CI: 1.74–3.77), and lack of diuretic use (OR = 1.89, 95% CI: 1.28–2.79) were independent risk factors for non-achievement.
Following 1 year of standardized management, blood pressure control rate increased to 58.4% (187/320, P < 0.001), with systolic pressure dropping from 152.3±16.7 to 131.5±12.4 mmHg and diastolic from 91.6±11.2 to 80.3±8.7 mmHg (both P < 0.001).

Study Design

Type

Cohort (n=320)

Multicenter

No

Structured PICO

Does a 1-year standardized multidisciplinary hypertension management program improve blood pressure control rate and renal function markers in patients with chronic kidney disease and comorbid hypertension?

P

Population

320 adults with chronic kidney disease and hypertension (mean age 56.8 years, 44.4% female) at a single center in China, followed for 12 months under a standardized management protocol.

I

Intervention

Standardized multidisciplinary hypertension management for 1 year (12 months), including: (1) standardized blood pressure monitoring (home BP twice daily morning and evening uploaded to system, ambulatory BP monitoring every 3 months); (2) individualized BP targets based on KDIGO 2021 guidelines (generally SBP < 120-130 mmHg, DBP < 80 mmHg); (3) rational pharmacotherapy based on ACEI/ARB, adding CCBs or diuretics, and adding mineralocorticoid receptor antagonists or SGLT2 inhibitors for resistant hypertension, with dose adjusted by eGFR; (4) lifestyle interventions (low-salt diet with sodium < 2 g/day, moderate exercise, weight loss, smoking cessation, alcohol restriction, psychological counseling); (5) multidisciplinary team management led by nephrologists in collaboration with cardiologists, nutritionists, clinical pharmacists, and specialist nurses with monthly or more frequent follow-ups.

C

Comparator

Baseline pre-intervention status (single-arm pre-post comparison with no parallel control group)

O

Outcome

Blood pressure control rate (defined as office blood pressure < 130/80 mmHg) at 12 monthssurrogate

Main Result

Absolute Event Rate: 58.4% vs 26.9%

p-value: p=< 0.001

In patients with chronic kidney disease and hypertension, a 1-year standardized multidisciplinary management strategy significantly improved blood pressure control rates from 26.9% to 58.4%, improved medication adherence, reduced proteinuria, and slowed eGFR decline.

Limitations

Single-center study with a relatively small sample size
Short follow-up duration of 1 year; long-term efficacy remains to be observed
Variable patient adherence to home blood pressure self-monitoring
Lack of a concurrent control group, unable to exclude the influence of time factors on results
Single-center study
Relatively small sample size
Short follow-up duration of 1 year, with long-term efficacy remaining to be observed
Varying patient compliance with home blood pressure monitoring may affect results
Lack of a control group comparison, making it impossible to rule out the effect of time on the results

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Implication

May support multidisciplinary BP programs in CKD hypertension; leaves open confirmation of renal benefits in randomized trials.

Abstract

目的：了解慢性肾脏病（CKD）患者高血压控制情况，探讨影响血压达标相关因素以及规范化管理模式对其有效性的评估。方法：采取前瞻性队列研究方式，选择自2022年1月至2024年6月在我院肾内科就诊并确诊为CKD 合并高血压患者共320名作为研究对象。第一部分是对横断面研究，收集患者的基线资料、血压水平、服药情况以及依从性等方面的内容，计算血压达标率及其相关的危险因素。第二部分是对入选的所有患者施行为期一年的规范化管理模式，即标准化血压监测、个体化降压目标、合理使用药物治疗、生活方式干预以及多学科合作进行管理，在此期间观察患者的血压达标率、肾功能变化情况以及依从性变化等。结果：在干预前，CKD患者中有26.9%（86/320）的人达到了理想的血压水平。经过多元回归分析发现CKD分期较高（OR = 2.14，95%CI：1.52-3.01）、服药依从性较差（OR = 3.27， 95%CI：2.18-4.91）、未定期随访测量血压（OR = 2.56，95%CI：1.74-3.77）以及未联用利尿剂（OR = 1.89，95%CI： 1.28-2.79）均为血压未达到目标值的独立风险因素。经过一年的规范化管理之后，患者的血压达标率上升到了58.4% （187/320），与干预前相比有非常明显的改善（P < 0.001）；收缩压从（152.3±16.7）mmHg降低到（131.5±12.4） mmHg，舒张压从（91.6±11.2）mmHg下降到（80.3±8.7）mmHg，两者均具有统计学意义（P < 0.001）。尿蛋白肌酐比从[386.5（152.3,782.6）]mg/g减少到[218.7（98.4,465.2）]mg/g，eGFR下降速度变慢，在两组之间存在显著差异（P < 0.05）。服药依从性评分由（5.2±1.8）分增加到（7.6±1.2）分（P < 0.001）。综上所述，CKD患者的高血压控制率较低，受到诸多因素的影响，如疾病严重程度、服药依从性、血压监测频率以及所使用的药物等。而规范化管理能明显提高血压达标率，有利于保护患者的肾脏功能，提高其服药依从性，具有较好的应用前景。

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Cite This Study

邱 et al. (2026) conducted a cohort in Chronic kidney disease (CKD) with hypertension (n=320). Standardized multidisciplinary hypertension management protocol (home and ambulatory BP monitoring, individualized KDIGO targets, ACEI/ARB-based pharmacotherapy with CCBs/diuretics/MRAs/SGLT2i, lifestyle modification, and multidisciplinary team follow-up) vs. Pre-intervention baseline status (single-group pre-post comparison) was evaluated on Blood pressure control rate (office blood pressure < 130/80 mmHg) (p=< 0.001).

synapsesocial.com/papers/6af3382456c0fd1f7f33d911 https://doi.org/10.37155/2661-4766-0807-29

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肾病患者高血压控制现状与规范化管理策略研究

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

肾病患者高血压控制现状与规范化管理策略研究

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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