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Published on: July 19, 2018
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Resistant and Apparently Resistant Hypertension in Peritoneally Dialyzed Patients
Bartosz Symonides1, Marlena Kwiatkowska-Stawiarczyk2, Jacek Lewandowski1
1Department of Internal Medicine, Hypertension and Vascular Diseases, Medical University of Warsaw, 02-097 Warsaw, Poland.
Journal of Clinical Medicine
|January 11, 2025
Summary
Resistant hypertension definitions need reevaluation for peritoneal dialysis patients. Current guidelines don't fit, necessitating new criteria considering adherence and residual kidney function for better blood pressure management.
Area of Science:
- Nephrology
- Cardiology
- Pharmacology
Background:
- Hypertension is prevalent in chronic kidney disease.
- Existing resistant hypertension definitions are inadequate for end-stage kidney disease and peritoneal dialysis patients.
- Limited data exists on hypertension epidemiology and apparent treatment-resistant hypertension (ATRH) in peritoneal dialysis.
Purpose of the Study:
- To review hypertension definitions, therapeutic targets, and limitations in peritoneal dialysis.
- To discuss the pathophysiology, diagnosis, and management of hypertension in this population.
- To present available data on ATRH prevalence in peritoneal dialysis patients.
Main Methods:
- Literature review focusing on hypertension in peritoneal dialysis.
- Analysis of existing definitions and their applicability.
- Synthesis of data on ATRH prevalence and management strategies.
Main Results:
- Standard resistant hypertension definitions do not apply to peritoneal dialysis.
- Apparent treatment-resistant hypertension (ATRH) is defined by medication use rather than BP control.
- Data on ATRH prevalence in peritoneal dialysis is scarce.
Conclusions:
- Peritoneal dialysis patients require redefined hypertension and ATRH criteria.
- Future studies should focus on larger populations with better adherence and consider residual kidney function.
- New definitions should incorporate residual kidney function for improved clinical outcomes.
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