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Hypertension in peritoneal dialysis patients: epidemiology, pathogenesis, and treatment

Luis M Ortega1, Barry J Materson

  • 1Department of Medicine, Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, Miami, Florida 33101, USA.

Journal of the American Society of Hypertension : JASH
|April 5, 2011
PubMed

Insights

Hypertension is common in peritoneal dialysis (PD) patients, increasing cardiovascular risks. Managing fluid overload and preserving residual renal function (RRF) are key to controlling blood pressure.

Area of Science:

  • Nephrology
  • Cardiology
  • Internal Medicine

Background:

  • Hypertension (HTN) affects 29%-80% of peritoneal dialysis (PD) patients.
  • Cardiovascular disease is the leading cause of mortality in PD patients.
  • Volume overload and loss of residual renal function (RRF) contribute to HTN in PD.

Purpose of the Study:

  • To review the prevalence and management of hypertension in PD patients.
  • To discuss the physiological factors influencing blood pressure in PD.
  • To outline therapeutic strategies for controlling HTN in this population.

Main Methods:

  • Literature review of studies on hypertension in PD.
  • Analysis of the role of peritoneal membrane physiology in fluid and solute transport.
  • Examination of current antihypertensive treatment options for PD patients.

Main Results:

  • Fluid overload due to high fluid intake and reduced RRF is a major driver of HTN.
  • Noncompliance with salt restriction exacerbates weight gain and HTN.
  • Peritoneal dialysis solutions, salt restriction, and antihypertensive medications are primary treatment modalities.

Conclusions:

  • Effective management of volume status is crucial for HTN control in PD.
  • Preserving RRF is vital for long-term volume management and blood pressure control.
  • A multi-faceted approach including ultrafiltration, dietary modification, and pharmacotherapy is necessary.

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