Blood pressure control in chronic hemodialysis patients

London, Gérard M.; Marchais, Sylvain J.; Guérin, Alain P.; Mëtivier, Fabien

doi:10.1007/978-1-4020-2275-3_29

Cited by 5 publications

(5 citation statements)

References 201 publications

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“…Another reason could be associated with accelerated ageing of arterial system with extensive calcification and stiffening of arterial walls. More recently, emerging evidence indicates that endothelial dysfunction may play a key role in hemodynamic instability during HD (15,16).…”

Section: Bp Metricmentioning

confidence: 99%

Frequency of intradialytic hypotensive episodes: old problem, new insights

Rocha

Sousa

Teles

et al. 2015

Journal of the American Society of Hypertension

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Symptomatic intradialytic hypotension (IDH) continues to be an important complication of hemodialysis treatment. There is some evidence that besides an IDH episode, repeated episodes could represent an even more important independent risk factor for mortality in hemodialysis patients. A retrospective cross-sectional study was performed to study 18 dialysis treatments in 43 patients during 6 weeks. Relationships of IDH episodes with baseline variables were examined using a Poisson regression model (generalized linear model). IDH was frequent (93% of patients) and highly variable by patient (0%-100%). Multivariate analysis showed that patients who experienced frequent hypotensive episodes had a lower dry weight (90% confidence interval [CI]: 0.95-0.99), higher phosphorus levels (90% CI: 1.07-1.47), greater prevalence of diabetes mellitus (90% CI: 1.11-2.71), and hypertension (90% CI: 1.04-2.45). Dry weight, hypertension, and phosphorus levels are modifiable risk factors to possibly reduce the rate of IDH episodes. The potential protective role of phosphorus warrants further investigation.

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Section: Bp Metricmentioning

confidence: 99%

Frequency of intradialytic hypotensive episodes: old problem, new insights

Rocha

Sousa

Teles

et al. 2015

Journal of the American Society of Hypertension

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“…Hypertension in chronic renal failure, but also in HD is characterized by an elevated SBP, while the DBP usually remains normal, even low. is leads to an increase in the differential, or pulse pressure, which is an independent risk factor for cardiovascular disease [10][11][12][13][14]. In our series, hypertension was systolic in more than 80% of cases.…”

Section: Discussionmentioning

confidence: 91%

Therapeutic Education's Role in the Management of Hypertension in Chronic Hemodialysis Patients

Haddiya¹,

Harraqui²,

Karimi³

et al. 2013

ISRN Hypertension

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The prevalence of hypertension remains high in hemodialysis (HD) patients, leading to a considerable morbimortality. The “dry weight method (DW),” established by Scribner, presents an undeniable interest in the management of hypertension in HD patients. Aim. The aim of our work was to determine the prevalence and risk factors (RFs) of hypertension in our chronic HD patients and try to reduce it by using a therapeutic education (TE) strategy based on Scribner’s recommendations. Patients and Methods. We led an interventional prospective study in three phases. In phase 1, we determined the prevalence of hypertension. In phase 2, hypertensive patients benefited of a TE strategy. In phase 3, we evaluated the effects of our TE. Results. Hypertension was noted in 57 patients. RFs for hypertension included age, important interdialytic weight gain (IDWG), noncompliance to the dietary rules, and a rhythm of 2 sessions of dialysis per week. The use of a TE strategy enabled us to correct hypertension in some of our HD patients. Conclusion. A TE strategy improved the hypertension rate in our HD unit. This success could not be conceived without an educational effort supported by the whole medical team.

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“…There are various pathogenic factors involved in dialysisrelated hypertension [36], and we cannot fully exclude that some of them have not played a role in the persistence of the elevated BP in group 2. However, the fluid overload is considered as the major factor that increases BP in HD patients [37][38][39], and the present study confirms the importance of removing the fluid overload for adequate BP control.…”

Section: Discussionmentioning

confidence: 92%