[Drug treatment of hypertension in hemodialysed patients]

A fraction of the dialyzed patients remains hypertensive despite achievement of the "dry weight" and will eventually require a pharmacological antihypertensive treatment. There is only scarce randomized intervention trials available in those patients so it is difficult to estimate whether the cardiovascular benefit of the treatment is related to blood pressure lowering per se or to class or drug specific properties. This paper reviews the different class of antihypertensive drugs focusing on their advantages and disadvantages in dialysis patients. On a practical ground, prescription will be driven by pharmacokinetics considerations and mostly according to specific indications pertinent to cardiovascular complications associated with hypertension.