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Dialysis

Dialysis

Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
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Updated: Aug 7, 2025

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion

Published on: May 26, 2022

Resistant hypertension in dialysis.

Bartosz Symonides¹, Jacek Lewandowski¹, Jolanta Małyszko²

¹Department of Internal Medicine, Hypertension and Vascular Diseases, Medical University of Warsaw, Warsaw, Poland.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association

|March 10, 2023

Summary

Hypertension is common in chronic kidney disease (CKD) patients. Current resistant hypertension definitions need adaptation for end-stage kidney disease (ESKD) patients on dialysis, requiring further research into measurement and targets.

Keywords:

apparent treatment-resistant hypertension end-stage kidney disease hemodialysis peritoneal dialysis resistant hypertension

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Published on: July 19, 2018

Area of Science:

Nephrology
Cardiology
Clinical Pharmacology

Background:

Hypertension affects 60-90% of chronic kidney disease (CKD) patients, increasing cardiovascular disease risk, CKD progression, and mortality.
Resistant hypertension (RH) is defined by uncontrolled blood pressure (BP) despite multiple antihypertensive drugs, but current definitions are not directly applicable to end-stage kidney disease (ESKD).
Apparent treatment-resistant hypertension (ATRH) is defined as uncontrolled BP on three or more medication classes, or four or more medications regardless of BP control.

Approach:

This review critically examines hypertension definitions and therapeutic targets in patients undergoing renal replacement therapy (RRT).
It discusses the pathophysiology and assessment of BP in the dialyzed population.
The review covers the management of RH and available data on ATRH prevalence in ESKD.

Key Points:

Established RH definitions require validation for ESKD patients on dialysis.
Accurate BP measurement methods and adherence confirmation are crucial for diagnosing true RH.
Further research is needed to establish optimal BP targets and refine RH definitions in the ESKD population.

Conclusions:

Larger, high-quality studies are essential to investigate drug adherence in ESKD patients on dialysis.
Standardized methods for BP measurement and clear target BP values are needed for this population.
Revisiting the definition of RH in ESKD and its clinical impact is a critical future direction.