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The Challenges of Blood Pressure Control in Dialysis Patients

Vito M Campese1, Ravi Lakdawala

  • 1Keck School of Medicine, USC, 2020 Zonal Ave, Los Angeles, CA 90033, USA. campese@usc.edu.

Recent Advances in Cardiovascular Drug Discovery
|November 17, 2015
PubMed

Insights

Hypertension is common in chronic kidney disease (CKD) and end-stage kidney disease (ESRD). This review addresses challenges in defining, diagnosing, and managing hypertension in these patients, including drug considerations.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Clinical Pharmacology

Background:

  • Hypertension is highly prevalent in patients with chronic kidney disease (CKD) and end-stage kidney disease (ESRD).
  • Significant challenges remain in the definition, variability, diagnosis, and management of hypertension within this patient population.
  • Unresolved clinical issues necessitate a comprehensive review of current practices.

Purpose of the Study:

  • To critically review the current challenges in defining, diagnosing, and treating hypertension in CKD and ESRD patients.
  • To examine the pharmacokinetics, pharmacodynamics, and safety profiles of antihypertensive drugs commonly used in these patients.
  • To provide insights into optimizing hypertension management in kidney disease.

Main Methods:

  • Literature review of current clinical practice guidelines and research.
  • Critical analysis of diagnostic criteria and therapeutic strategies for hypertension in CKD/ESRD.
  • Review of pharmacokinetic and pharmacodynamic data for antihypertensive medications.

Main Results:

  • Identified significant gaps and controversies in hypertension definition and diagnosis in CKD/ESRD.
  • Highlighted variability in blood pressure readings and treatment responses.
  • Summarized the evidence on various antihypertensive drug classes, noting specific considerations for kidney patients.

Conclusions:

  • Effective management of hypertension in CKD and ESRD requires addressing current clinical practice challenges.
  • Understanding drug pharmacokinetics, pharmacodynamics, and safety is crucial for effective antihypertensive therapy in kidney disease.
  • Further research is needed to refine diagnostic and therapeutic approaches for hypertension in CKD/ESRD patients.

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