High Blood Pressure in Dialysis Patients: Cause, Pathophysiology, Influence on Morbidity, Mortality and Management

Stern, Aaron; Sachdeva, Sandeep; Kapoor, Rohit; Singh, J B; Sachdeva, Sarthak

doi:10.7860/jcdr/2014/8253.4471

Cited by 21 publications

(27 citation statements)

References 41 publications

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“…The subjects were classifed into 3 groups, namely controlled hypertension group (BP ≤ 140/90 mmHg), uncontrolled hypertension group (BP>140/90 mmHg) and normal group as standard (BP≤120/80 mmHg). 7 More than half of the subjects were male (59.09%), aged 51-60 years old (45.45%). Increased risk of CRF was observed for those who aged > 55 (male) and > 65 (female) due to decreased organ functions and regulating hormones.…”

Section: Resultsmentioning

confidence: 99%

“…Several studies have shown that administration of Epo may reduce hospital admissions and improve the quality of life of patients. 7,8 One of the factors that aggravates CRF in hemodialysis patient is the presence of other complicating medical condition such as uncontrolled hypertension. Several hypertensive guidelines highlight the importance of lowering blood pressure (BP) to slow the progression of CRF.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of Erythropoietin in Hypertensive Hemodialysis Patients

Ibrahim¹,

Diantini²,

Prihartanto³

et al. 2017

PCPR

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Chronic renal failure (CRF) is one the most prevalent health problems among the elderly. On the fifth stage of CRF, the patient becomes eligible to hemodialysis. CRF-induced anemia is commonly treated with Erythropoietin (Epo). Information regarding the effectiveness of Epo in hypertensive hemodialysis patients was limited. Therefore, this study was conducted to evaluate the effectiveness of Epo in hypertensive hemodialysis patients. This study used an observational case-control analytic method. Data were retrieved from the medical records of hemodialysis patients during March-May 2014. A total of 54 participants were included. The increase of haemoglobin (Hb) in controlled hypertension was 0.6257 g/dl, while the in uncontrolled hypertension group, there was a decrease in Hb (-0.1590 g/dl). The use of Epo was more effective in hemodialysis patients with controlled hypertension.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effectiveness of Erythropoietin in Hypertensive Hemodialysis Patients

Ibrahim¹,

Diantini²,

Prihartanto³

et al. 2017

PCPR

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“…Target BP level is not as clearly defined in HD patients as in patients with normal renal function. Both high and low BP correlate with increased cardiovascular morbidity and mortality, but it is still common practice to use BP as the assay variable when probing for DW …”

Section: Discussionmentioning

confidence: 99%

Clinical praxis for assessment of dry weight in Sweden and Denmark: A mixed‐methods study

Stenberg

Lindberg

Furuland

2015

Hemodialysis International

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Overhydration is an independent predictor of mortality in hemodialysis (HD) patients. More than 30% of HD patients are overhydrated, motivating the development of new methods for assessing hydration status. This study surveyed clinical praxis and local guidelines for dry weight (DW) assessment in Swedish and Danish HD units, and examined if differences in routines and utilization of bioimpedance spectroscopy (BIS) and other assistive technology affected frequency of DW adjustments and blood pressure (BP) levels. Cross-sectional information on praxis, guidelines and routines, plus treatment-related data from 99 stratified patients were collected. Qualitative data were analyzed with content analysis and interpreted in convergence with statistical analysis of quantitative data in a mixed-methods design. Local guidelines concerning DW existed in 54% of the units. A BIS device was present in 52%, but only half of those units used it regularly, and no correlations to frequency of DW adjustments or BP were found. HD nurses were authorized to adjust DW in 60% of the units; in these units, the frequency of DW adjustments was 1.6 times higher and systolic BP pre-HD 8 mmHg lower. There is a wide variation in routines for DW determination, and there are indications that authorization of HD nurses to adjust DW may improve DW assessment. BIS is sparsely used; its implementation may have been delayed by uncertainty over how to manage the device and interpret measurements. Hence, better methods and guidelines for assessing DW and using BIS need to be developed.

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“…Different hypertensive mechanisms have been described in this patient category. Indeed, fluid overload, dialysate calcium content and renin-angiotensin hyperactivity are the most frequent causes of high blood pressure (BP) in patients on extracorporeal renal replacement therapy [15]. However, other hypertensive mechanisms have also been described.…”

Section: Introductionmentioning

confidence: 99%

Secondary Hyperparathyroidism and Hypertension: An Intriguing Couple

Simeoni

Perna

Fuiano

2020

JCM

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Secondary hyperparathyroidism (SHPTH) is a major complication in patients on maintenance hemodialysis burdened with high cardiovascular risk. Hypertension is also a high prevalence complication contributing to an increase in the mortality rate in hemodialysis patients. A possible association between SHPTH and hypertension has been widely reported in the literature and several pathogenetic mechanisms have been described. There is evidence that the decrease of plasma iPTH levels are correlated with hypertension correction in hemodialysis patients undergoing parathyroidectomy and oral calcimimetics administration. We have observed a similar behaviour also in a patient on chronic hemodialysis treated with Etelcalcetide. Even if this is an isolated observation, it could stimulate future investigation, possibly in dedicated clinical trials.

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High Blood Pressure in Dialysis Patients: Cause, Pathophysiology, Influence on Morbidity, Mortality and Management

Cited by 21 publications

References 41 publications

Effectiveness of Erythropoietin in Hypertensive Hemodialysis Patients

Effectiveness of Erythropoietin in Hypertensive Hemodialysis Patients

Clinical praxis for assessment of dry weight in Sweden and Denmark: A mixed‐methods study

Secondary Hyperparathyroidism and Hypertension: An Intriguing Couple

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