Profile of antihypertensive drugs in hypertensive patients on renal replacement therapy (RRT)

Hypertension is frequently observed in end-stage renal failure. We analysed the incidence and severity of hypertension as well as antihypertensive treatment in a large group of patients on renal replacement therapy (RRT). Questionnaires were sent to all 49 dialysis centers caring for a total of 2090 patients on RRT in Austria. Hypertension was classified as mild, moderate or severe according to WHO criteria. 22 dialysis centers returned completed questionnaires accounting for 1087 patients on RRT. Of these 653 (60%) patients were hypertensive; 425 (39%) patients had mild or moderate, while 228 (21%) patients had severe hypertension. Patients with mild or moderate hypertension need on average 1.5, while those with severe hypertension on average 3.3 antihypertensive drugs. Calcium antagonists were the antihypertensive drugs most frequently administered, in 71% of the patients, followed by ACE inhibitors, alpha- and beta-blockers. Despite multidrug antihypertensive therapy severe hypertension is still a serious problem in patients on RRT. Tassin's center experience showed that longer dialysis time normalizes hypertension and reduces the requirement of antihypertensive treatment in patients on hemodialysis.