Document Detail


Blood pressure management in hemodialysis: what have we learned?
MedLine Citation:
PMID:  20827194     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: To review recent developments in the field of hypertension in hemodialysis patients.
RECENT FINDINGS: Despite the fact that hypertension is the most common complication of end-stage kidney disease, no evidence-based blood pressure (BP) targets exist for hemodialysis patients. There is growing evidence that outcomes are better predicted by out-of-office BP values, such as home or ambulatory BP monitoring. Intradialytic hypertension is associated with increased risk of death or hospitalization, and is probably mediated by volume overload. BP management should focus on volume control: dry weight 'probing' is well tolerated and effective in lowering BP, as are other strategies that minimize expansion of the extracellular fluid volume, such as avoidance of hypernatric dialysate. We discuss each of these issues in our review.
SUMMARY: Modest advances in the understanding of hypertension have occurred in the past 2 years. Clinical trials that focus on BP targets and treatment choices are essential to guide future practice.
Authors:
Aldo J Peixoto; Sergio F F Santos
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Review    
Journal Detail:
Title:  Current opinion in nephrology and hypertension     Volume:  19     ISSN:  1473-6543     ISO Abbreviation:  Curr. Opin. Nephrol. Hypertens.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-15     Completed Date:  2011-02-01     Revised Date:  2013-05-02    
Medline Journal Info:
Nlm Unique ID:  9303753     Medline TA:  Curr Opin Nephrol Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  561-6     Citation Subset:  IM    
Affiliation:
Medical Service, VA Connecticut Healthcare System, West Haven, CT, USA. aldo.peixoto@yale.edu
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MeSH Terms
Descriptor/Qualifier:
Antihypertensive Agents / therapeutic use*
Blood Pressure*
Blood Pressure Determination / methods
Evidence-Based Medicine
Extracellular Fluid / metabolism
Humans
Hypertension / etiology,  physiopathology,  therapy*
Kidney Failure, Chronic / complications,  physiopathology,  therapy*
Practice Guidelines as Topic
Renal Dialysis* / adverse effects
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antihypertensive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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