Hypertension and dialysis

Kidney & Blood Pressure Research
Matthias P Hörl, Walter H Hörl

Abstract

The high mortality rate seen in dialysis patients is related to long-standing high blood pressure and the presence of other traditional as well as non-traditional risk factors for cardiovascular disease. Hypertension is associated with increased risk for left ventricular hypertrophy, coronary artery disease, congestive heart failure and cerebrovascular complications. High blood pressure is frequent and difficult to control in the dialysis population. Available therapeutic options to normalize blood pressure in these patients include dietary salt and fluid restriction in combination with reduction of dialysate sodium concentration. A possible treatment option for these patients may be long, slow hemodialysis (3 x 8 h per week); short daily hemodialysis (2-3 h 7 times per week); nocturnal hemodialysis (6-7 times overnight per week). Reduction of residual renal function is a major cause of blood pressure increase in the peritoneal dialysis patient population. Therefore, hyperhydration should be avoided. If antihypertensive medication is needed, ACE inhibitors, beta-blockers and/or calcium channel blockers are recommended. Optimal blood pressure in dialysis patients is not different from recommendations for the general population.

Citations

May 29, 2004·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Hiromichi SuzukiHidetomo Nakamoto
Mar 11, 2008·The Journal of Clinical Hypertension·Mihály TapolyaiAtif Fakhruddin
Sep 8, 2004·Transplantation Proceedings·H YassaA Ibrahim
Jun 25, 2004·Advances in Chronic Kidney Disease·Mark E Williams
Jan 12, 2005·Journal of Hypertension·Hormaz DastoorM Gary Nicholls

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