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Control of hypertension is better during hemodialysis than during continuous ambulatory peritoneal dialysis in ESRD

M T Velasquez1, S Q Lew, B von Albertini

  • 1Department of Medicine, George Washington University Medical Center Washington, DC 20037, USA.

Clinical Nephrology
|January 23, 1998
PubMed

Insights

Hypertension control is better with hemodialysis (HD) than continuous ambulatory peritoneal dialysis (CAPD) in end-stage renal disease (ESRD) patients. CAPD patients required more antihypertensive drugs and had less adequate blood pressure control compared to HD.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine

Background:

  • End-stage renal disease (ESRD) necessitates renal replacement therapy.
  • Hypertension is a common complication in ESRD patients.
  • Hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) are primary treatment modalities for ESRD.

Purpose of the Study:

  • To compare the status and adequacy of blood pressure (BP) control in ESRD patients undergoing HD versus CAPD.
  • To investigate factors influencing BP control in these two dialysis modalities.

Main Methods:

  • A comparative study involving 21 ESRD patients treated with both HD and CAPD at different time points.
  • Assessment of antihypertensive medication usage and BP levels (systolic and diastolic).
  • Evaluation of ultrafiltration rates, Kt/V, hematocrit, recombinant human erythropoietin (rHuEpo) usage, body weight, and serum albumin.

Main Results:

  • A significantly higher proportion of patients required antihypertensive drugs during CAPD (71%) compared to HD (43%).
  • Adequate hypertension control was achieved in significantly fewer patients during CAPD (52%) versus HD (81%).
  • Patients on CAPD exhibited higher mean body weight and lower serum albumin levels compared to HD.

Conclusions:

  • Hypertension is less adequately controlled during CAPD compared to HD in ESRD patients.
  • Increased total body fluid volume, suggested by weight gain during CAPD, may contribute to poorer hypertension management.
  • HD appears to be a more effective modality for managing hypertension in ESRD patients.

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