Hypertension control with daily dialysis. Semin Dial 2004;17(4):295-8
Date
07/15/2004Pubmed ID
15250921DOI
10.1111/j.0894-0959.2004.17330.xScopus ID
2-s2.0-4243146154 (requires institutional sign-in at Scopus site) 23 CitationsAbstract
Hypertension is present in 60-90% of patients on maintenance hemodialysis (HD) and it is an important cause of cardiovascular (CV) mortality and morbidity. Frequent and prolonged HD has been uniformly shown to control hypertension in end-stage renal disease (ESRD) patients more effectively than conventional HD. The etiology of hypertension is predominantly volume dependent, but in a subset of patients increased renin, sympathetic overactivity, and endothelial dysfunction may play a role. Intradialytic hypotension precludes attainment of dry weight and hence optimal control of hypertension in conventional HD is challenging. Frequent and prolonged dialysis with gentle and persistent ultrafiltration allows time for refilling of the intravascular compartment and permits normalization of extracellular volume. It is also possible that intensive dialysis enables removal of pressor molecules and improves endothelial function. Improved blood pressure control translates into regression of left ventricular hypertrophy in patients on daily HD. Thus prolonged and frequent dialysis permits better control of hypertension via volume and volume-independent mechanisms and also improves cardiac geometry.
Author List
Saad E, Charra B, Raj DSAuthor
Ehab R. Saad MD Director, Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
HumansHypertension
Kidney Failure, Chronic
Renal Dialysis