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The management of hypertension in hemodialysis and CAPD patients

M Malliara1

  • 1General Hospital of Katerini, Katerini, Greece. malliara@hol.gr

Hippokratia
|July 8, 2009
PubMed

Insights

Hypertension management in dialysis patients is crucial for preventing cardiovascular disease. Achieving dry weight and limiting sodium intake, alongside recommended medications, helps control blood pressure and improve outcomes.

Area of Science:

  • Nephrology
  • Cardiology
  • Internal Medicine

Background:

  • Chronic kidney disease (CKD) frequently progresses to end-stage renal disease (ESRD), with approximately 86% of patients diagnosed with hypertension.
  • Hypertension is a significant risk factor for cardiovascular disease (CVD), the primary cause of morbidity and mortality in the dialysis population.

Purpose of the Study:

  • To review the management strategies for hypertension in patients undergoing hemodialysis.
  • To emphasize the importance of blood pressure control for reducing cardiovascular risk in ESRD patients.

Main Methods:

  • Review of current literature and clinical guidelines on hypertension management in dialysis patients.
  • Discussion of pathophysiological determinants, therapeutic targets, and pharmacological interventions.

Main Results:

  • Optimal pre- and post-dialysis blood pressure is recommended below 140/90 mmHg.
  • Extracellular volume expansion is a key factor in dialysis-related hypertension.
  • Angiotensin II receptor antagonists, beta blockers, and calcium channel blockers are recommended first-line antihypertensive drugs.

Conclusions:

  • Effective management of hypertension in hemodialysis patients requires addressing extracellular volume and sodium intake.
  • Antihypertensive drug therapies are essential for the majority of hemodialysis patients, with beta blockers and calcium channel blockers offering protective cardiovascular benefits.

Keywords:
cardiovascular diseasehemodialysishypertensionperitoneal dialysis

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