Document Detail

Management of intradialytic hypertension: the ongoing challenge.
MedLine Citation:
PMID:  16551292     Owner:  NLM     Status:  MEDLINE    
There is no widely accepted definition of intradialytic hypertension. Arbitrary clinical definitions have included an increase in blood pressure during or immediately after hemodialysis, a rise in blood pressure during the second or third hour of dialysis, and an increase in blood pressure that is resistant to ultrafiltration. To date, no studies have evaluated the prevalence and prognostic importance of intradialytic hypertension. The pathogenesis of intradialytic hypertension is complex and is due in part to extracellular fluid volume expansion, increased cardiac output, activation of the renin-angiotensin system and the sympathetic nervous system, increased circulating vasoactive substances resulting in peripheral vasoconstriction, erythropoietin use, and fluctuations in electrolytes and removal of antihypertensive medications during the dialysis procedure. Management strategies of intradialytic hypertension are based on expert opinion using the pathophysiologic principles described above. We conclude that additional epidemiologic, basic science, and interventional studies are needed to further elucidate the prevalence, prognostic importance, pathophysiology, and potential treatment of intradialytic hypertension.
Joline Chen; Ambreen Gul; Mark J Sarnak
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Seminars in dialysis     Volume:  19     ISSN:  0894-0959     ISO Abbreviation:  Semin Dial     Publication Date:    2006 Mar-Apr
Date Detail:
Created Date:  2006-03-22     Completed Date:  2006-09-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8911629     Medline TA:  Semin Dial     Country:  United States    
Other Details:
Languages:  eng     Pagination:  141-5     Citation Subset:  IM    
Division of Nephrology, Department of Medicine, Tufts-New England Medical Center, Boston, Massachusetts 02111, USA.
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MeSH Terms
Arginine / analogs & derivatives,  physiology
Blood Volume / physiology
Calcium / blood
Cardiac Output / physiology
Endothelin-1 / physiology
Erythropoietin, Recombinant / adverse effects
Hypertension / epidemiology,  etiology*,  physiopathology,  therapy*
Nitric Oxide / physiology
Potassium / blood
Renal Dialysis / adverse effects*,  methods
Renin-Angiotensin System / physiology
Sodium / blood
Sympathetic Nervous System / physiopathology
Reg. No./Substance:
0/Endothelin-1; 0/Erythropoietin, Recombinant; 10102-43-9/Nitric Oxide; 30315-93-6/N,N-dimethylarginine; 74-79-3/Arginine; 7440-09-7/Potassium; 7440-23-5/Sodium; 7440-70-2/Calcium

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

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