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Hypertension in Dialysis Patients: Diagnostic Approaches and Evaluation of Epidemiology

Panagiotis I Georgianos1, Vasilios Vaios1, Vasiliki Sgouropoulou1

  • 1Section of Nephrology and Hypertension, 1st Department of Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.

Diagnostics (Basel, Switzerland)
|December 23, 2022
PubMed

Insights

Accurate hypertension diagnosis in dialysis patients is crucial. Home or ambulatory blood pressure (BP) monitoring is superior to in-unit measurements for assessing risk and prognosis.

Area of Science:

  • Nephrology
  • Cardiology
  • Hypertension Research

Background:

  • Hypertension is a known cardiovascular risk factor in the general population.
  • Its role in dialysis patients is debated due to diagnostic challenges.
  • Reverse epidemiology suggests U-shaped or J-shaped BP-mortality associations with routine dialysis unit measurements.

Purpose of the Study:

  • To explore the accuracy of different blood pressure (BP) measurement methods in diagnosing hypertension in dialysis patients.
  • To describe how hypertension epidemiology differs based on BP assessment location (dialysis unit vs. home/ambulatory).

Main Methods:

  • Review of evidence on BP measurement accuracy in dialysis patients.
  • Comparison of dialysis-unit BP recordings with home and ambulatory BP monitoring.
  • Analysis of associations with cardiovascular morbidity, mortality, and target-organ damage.

Main Results:

  • Dialysis-unit BP measurements may not accurately diagnose hypertension in this population.
  • Home and ambulatory BP monitoring are superior for diagnosis, target-organ damage detection, and prognosis.
  • BP measurement method significantly modifies the observed epidemiology of hypertension in dialysis patients.

Conclusions:

  • Accurate hypertension diagnosis in dialysis patients requires methods beyond routine dialysis-unit recordings.
  • Home or ambulatory BP monitoring offers a more reliable assessment of cardiovascular risk and mortality.
  • Re-evaluating hypertension management strategies based on accurate BP measurement is essential for this patient group.

Keywords:
ambulatory BP monitoringdiagnosisdialysisepidemiologyhome BP monitoringhypertension

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