Document Detail


The internist's role in treating hypertension in hemodialysis patients.
MedLine Citation:
PMID:  19383610     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Hypertension in hemodialysis patients is typically treated with a combination of volume removal with dialysis--although limited by current dialysis paradigms--and hypertension medications. Unfortunately, most patients treated in this manner remain hypertensive. This contrasts with superior results obtained in clinical studies in which salt restriction and augmented dialytic volume removal normalized blood pressure without requiring medicines. These results are consistent with the role of excess volume as the main etiology of hypertension in end-stage renal disease (ESRD). Interdialytic blood pressure is now recognized as important to patient prognosis. These measurements are frequently obtained by internists at office visits. Internists and nephrologists should address both peri-dialysis and interdialysis hypertension in a collaborative manner. This strategy should focus on, as much as reasonably possible, salt restriction and dialytic volume removal rather than hypertension medicines.
Authors:
S Hirsch
Publication Detail:
Type:  Journal Article     Date:  2009-04-21
Journal Detail:
Title:  QJM : monthly journal of the Association of Physicians     Volume:  102     ISSN:  1460-2393     ISO Abbreviation:  QJM     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9438285     Medline TA:  QJM     Country:  England    
Other Details:
Languages:  eng     Pagination:  501-7     Citation Subset:  IM    
Affiliation:
Division of Nephrology, Mercy Hospital, Chicago, IL, USA. shelman100@aol.com
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Comments/Corrections
Comment In:
QJM. 2009 Dec;102(12):889-90   [PMID:  19671670 ]

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