The controversies of diagnosing and treating hypertension among hemodialysis patients
- PMID: 22686564
- PMCID: PMC3400711
- DOI: 10.1111/j.1525-139X.2012.01092.x
The controversies of diagnosing and treating hypertension among hemodialysis patients
Abstract
This review discusses 10 current controversies regarding the dialysis patient with hypertension. The clinician is faced with a dilemma at the bedside on how to evaluate blood pressure and treat this condition in a patient on long-term hemodialysis. The evidence base to give firm recommendations is thin, but the epidemiological evidence tells us to do nothing. This appears to be an incorrect strategy, at least based on what we know today. Evaluating home BP in every dialysis patient, evaluating volume status on a regular basis, and treating hypertension predominantly with nonpharmacological strategies are worthwhile.
© 2012 Wiley Periodicals, Inc.
Similar articles
-
Blood pressure management in hemodialysis: what have we learned?Curr Opin Nephrol Hypertens. 2010 Nov;19(6):561-6. doi: 10.1097/MNH.0b013e32833f0d82. Curr Opin Nephrol Hypertens. 2010. PMID: 20827194 Review.
-
How should hypertension be assessed and managed in hemodialysis patients? Home BP, not dialysis unit BP, should be used for managing hypertension.Semin Dial. 2007 Sep-Oct;20(5):402-5. doi: 10.1111/j.1525-139X.2007.00314.x. Semin Dial. 2007. PMID: 17897244 Review. No abstract available.
-
Dry-weight: a concept revisited in an effort to avoid medication-directed approaches for blood pressure control in hemodialysis patients.Clin J Am Soc Nephrol. 2010 Jul;5(7):1255-60. doi: 10.2215/CJN.01760210. Epub 2010 May 27. Clin J Am Soc Nephrol. 2010. PMID: 20507951 Free PMC article. Review.
-
The Clinical Problems of Hypertension Treatment in Hemodialysis Patients.Curr Vasc Pharmacol. 2017;16(1):54-60. doi: 10.2174/1570161115666170414120921. Curr Vasc Pharmacol. 2017. PMID: 28413966 Review.
-
Ambulatory blood pressure monitoring and peri-hemodialysis blood pressures in a southeast US hemodialysis unit.Clin Nephrol. 2012 May;77(5):383-91. doi: 10.5414/cn107138. Clin Nephrol. 2012. PMID: 22551884
Cited by
-
Rationale and design of the Sodium Lowering In Dialysate (SoLID) trial: a randomised controlled trial of low versus standard dialysate sodium concentration during hemodialysis for regression of left ventricular mass.BMC Nephrol. 2013 Jul 15;14:149. doi: 10.1186/1471-2369-14-149. BMC Nephrol. 2013. PMID: 23855560 Free PMC article. Clinical Trial.
-
Effect of Low-Sodium versus Conventional Sodium Dialysate on Left Ventricular Mass in Home and Self-Care Satellite Facility Hemodialysis Patients: A Randomized Clinical Trial.J Am Soc Nephrol. 2020 May;31(5):1078-1091. doi: 10.1681/ASN.2019090877. Epub 2020 Mar 18. J Am Soc Nephrol. 2020. PMID: 32188697 Free PMC article. Clinical Trial.
-
Which dialysis unit blood pressure is the most accurate for predicting home blood pressure in patients undergoing hemodialysis?Korean J Intern Med. 2017 Jan;32(1):117-124. doi: 10.3904/kjim.2015.278. Epub 2016 Apr 7. Korean J Intern Med. 2017. PMID: 27052263 Free PMC article.
-
Hypertension in hemodialysis patients: an opinion-based update.Semin Dial. 2014 Mar;27(2):146-53. doi: 10.1111/sdi.12195. Epub 2014 Feb 5. Semin Dial. 2014. PMID: 24494716 Free PMC article. Review.
-
Evidence-based cardiology in hemodialysis patients.J Am Soc Nephrol. 2013 Dec;24(12):1934-43. doi: 10.1681/ASN.2013060632. Epub 2013 Oct 17. J Am Soc Nephrol. 2013. PMID: 24136920 Free PMC article. Review.
References
-
- Levin NW, Kotanko P, Eckardt KU, Kasiske BL, Chazot C, Cheung AK, Redon J, Wheeler DC, Zoccali C, London GM. Blood pressure in chronic kidney disease stage 5D-report from a Kidney Disease: Improving Global Outcomes controversies conference. Kidney Int. 2010;77:273–284. - PubMed
-
- K/DOQI clinical practice guidelines for cardiovascular disease in dialysis patients. Am J Kidney Dis. 2005;45:S1–153. - PubMed
-
- Agarwal R. Systolic hypertension in hemodialysis patients. Semin Dial. 2003;16:208–213. - PubMed
Publication types
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Full Text Sources
Medical
