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Understanding Hypertension in Patients on Hemodialysis

Zorica Kauric-Klein

    Nephrology Nursing Journal : Journal of the American Nephrology Nurses' Association
    |August 21, 2015
    PubMed

    Insights

    Hypertension is common and poorly managed in hemodialysis (HD) patients, increasing cardiovascular risks. Understanding its complex causes and management strategies is crucial for nurses to improve blood pressure (BP) control.

    Area of Science:

    • Nephrology
    • Cardiology
    • Nursing

    Background:

    • Hypertension is highly prevalent and inadequately controlled in hemodialysis (HD) patients.
    • Poorly controlled hypertension in HD patients significantly elevates risks for cardiovascular morbidity and mortality.
    • The pathophysiology of hypertension in HD patients is complex and multifactorial.

    Purpose of the Study:

    • To summarize the pathophysiology of hypertension in patients undergoing hemodialysis.
    • To review current literature on managing hypertension in end-stage renal disease (ESRD) patients.
    • To inform nurses about blood pressure (BP) goals and interventions for improving BP control in HD patients.

    Main Methods:

    • Literature review of studies on hypertension in hemodialysis patients.
    • Synthesis of information on underlying pathophysiological mechanisms.
    • Compilation of data on nonpharmacological and pharmacological interventions.

    Main Results:

    • Hypertension in HD patients stems from complex, multifactorial causes.
    • Effective management requires knowledge of pathophysiology, BP targets, and interventions.
    • Interventions focus on improving BP control during and between HD sessions.

    Conclusions:

    • Nurses require comprehensive knowledge of hypertension in HD patients for optimal care.
    • Addressing the multifactorial nature of hypertension is key to improving outcomes.
    • Literature review supports a multifaceted approach to managing hypertension in ESRD.

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