Hypertension in Hemodialysis Patients: An Opinion‐Based Update

Shafi, Tariq; Waheed, Sana; Zager, Philip G.

doi:10.1111/sdi.12195

Cited by 13 publications

(11 citation statements)

References 76 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This hypothesis has been sustained and confirmed by other authors describing a mechanism by which, following the post-surgery iPTH lowering, the removal of calcium from the vessel walls might explain a blood pressure improvement related to vessel stiffness reduction [20]. Hypertension is another relevant and highly prevalent cardiovascular risk factor in hemodialysis patients, as widely reported in the literature [10][11][12][13][14]. Different hypertensive mechanisms have been described in this patient category.…”

Section: The Pathogenetic Cross-link Between Hypertension and Hyperpasupporting

confidence: 72%

“…In SHPTH, in fact, normal calcium deposition in bone tissue is diverted into vascular wall inducing atherosclerosis worsening [9]. Hypertension is another relevant and highly prevalent cardiovascular risk factor in hemodialysis patients, as widely reported in the literature [10][11][12][13][14]. Different hypertensive mechanisms have been described in this patient category.…”

Section: Introductionmentioning

confidence: 93%

See 1 more Smart Citation

Secondary Hyperparathyroidism and Hypertension: An Intriguing Couple

Simeoni

Perna

Fuiano

2020

JCM

View full text Add to dashboard Cite

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.

show abstract

Section: The Pathogenetic Cross-link Between Hypertension and Hyperpasupporting

confidence: 72%

Section: Introductionmentioning

confidence: 93%

Secondary Hyperparathyroidism and Hypertension: An Intriguing Couple

Simeoni

Perna

Fuiano

2020

JCM

View full text Add to dashboard Cite

show abstract

“…10,11 Meticulous adjudication of medical records can improve ascertainment of CVD. However, in a recent report of the Hemodialysis (HEMO) Study, the association between predialysis systolic BP and mortality did not change even after adjustment for adjudicated comorbidities.…”

mentioning

confidence: 99%

Troponin I and NT-proBNP and the Association of Systolic Blood Pressure With Outcomes in Incident Hemodialysis Patients: The Choices for Healthy Outcomes in Caring for ESRD (CHOICE) Study

Shafi

Zager

Sozio

et al. 2014

American Journal of Kidney Diseases

Self Cite

View full text Add to dashboard Cite

Background There is uncertainty regarding treatment of hypertension in hemodialysis patients due to the observed J-shaped association between blood pressure (BP) and death. We hypothesized that this association reflects confounding by cardiovascular disease (CVD) and that stratification by CVD biomarkers, cardiac troponin I (cTnI) and N-terminal fragment of prohormone brain natriuretic peptide (NT-proBNP), might change this association. Study Design National prospective cohort study. Setting & Participants 446 incident hemodialysis patients. Predictor Predialysis systolic BP. Outcomes Mortality (all-cause and CVD) and first CVD event assessed using Cox regression adjusted for demographics, comorbidities and clinical factors. Measurements Participants with cTnI ≥0.1 ng/mL or NT-proBNP ≥9,252 pg/mL classified as the high biomarker group; remaining participants included in the low biomarker group. Results Participants in the high biomarker group (n=138 [31%]) were older (61 versus 57 years) and had higher prevalence of CVD (67% versus 23%) but similar baseline BP (152 versus 153 mm Hg). There were 323 deaths (143 from CVD) and 271 CVD events. The high-biomarker group had higher risk of mortality than low biomarker group (HR, 1.75; 95% CI, 1.37–2.24). The association between BP and outcomes differed among the two biomarker groups (p for interaction of 0.01, 0.16 and 0.07 for all-cause mortality, CVD mortality and first CVD event, respectively). In the low biomarker group, BP was associated with a greater risk: HR per 10–mm Hg higher BP of 1.07 [95% CI, 1.01–1.14], 1.10 [95% CI, 0.96–1.25], and 1.04 [95% CI, 0.96–1.13] for all-cause mortality, CVD mortality, and first CVD event, respectively. Importantly, lower BP was not associated with an increased risk of outcomes in stratified models including among those with high biomarkers. Limitations BP measurements not standardized. Conclusions The observed J-shaped association between BP and outcomes in hemodialysis patients is due to confounding by subclinical CVD. A stratification approach based on cTnI and NT-proBNP has the potential to inform BP treatment in hemodialysis patients.

show abstract

“…Ayrıca SDBY hastalarında en yüksek oranda bulunmaktadır (31). HD'e yeni başlanan hastaların yaklaşık %80'i hipertansif seyretmekte, HD tedavisi ve antihipertansif tedavi sonrasında kontrol altına alınabilmektedir.…”

Section: Türk Nefroloji Diyaliz Ve Transplantasyon Dergisi Turkish Neunclassified

Evaluation of Urgent Hemodialysis in Maintenance Hemodialysis Patients: A 2-Year Retrospective Single Center Study

Gülle¹,

Yıldırım²,

Karakaş³

et al. 2016

Turk Neph Dial Transpl

View full text Add to dashboard Cite

ÖzAMAÇ: Son dönem böbrek yetmezliği (SDBY) tanısı ile izlenen olguların acil hemodiyalize (HD) alınması morbidite ve mortaliteyi ciddi oranda artırmaktadır. Çalışmamızda, rutin HD programında olan hastaların acil HD endikasyonlarını, kalıcı kateter ve arteriyovenöz fistülü (AVF) olan hastaların özelliklerini sorgulamayı amaçladık. GEREÇ ve YÖNTEMLER:Kasım 2013 -Kasım 2015 tarihleri arasında acil servise başvurusunun ardından acil HD'e alınan 18 yaş üstü 242 hastanın verileri, geriye dönük olarak incelenmiştir. Hastaların sosyodemografik özellikleri, komorbid hastalıkları kaydedilmiştir. Dış merkezden HD amacı ile sevk edilen hastalar, fazla ilaç ve toksik madde alımı olan hastalar ve yoğun bakım ünitelerinde HD'e alınan hastalar çalışmaya dahil edilmemiştir.BUlGUlAR: Çalışmaya (% 50,4) 122 erkek, (%49,6) 120 kadın hasta alındı. Yaş ortalaması 61,7 yıldı. Çalışmadaki hastaların %47,1'inde diyabetes mellitus (DM), %63,1'inde hipertansiyon (HT) saptandı. Hastaların ortalama HD'e girme süresi 37,6 ay olarak bulundu. Hastaların %55'inde AVF mevcut iken, %45'i tünelli kateter ile HD'e girmekteydi. Acil servise başvuru şikayetleri sıklık sırasıyla nefes darlığı (%38,2), bulantı-kusma (%20,2), serebrovasküler olay (SVO) (%7,02), kateter ilişkili sorunlar (%6,2) ve diğer nedenler olarak saptandı. Hastaların acil HD endikasyonları ise sıklık sırasına göre; hipervolemi (%31,8), hiperkalemi (%22,7), üremik bulgular (%21) ve metabolik asidoz (%19,2) olarak saptandı. Her iki grup arasında yaş ile birlikte kalıcı tünelli kateter kullanımı artmış olarak saptanmakla birlikte (p<0,01), ortalama HD'e girme süresi AV fistülü olan hastalarda daha uzun ve istatistiki olarak anlamlı saptandı (p<0,01). SONUÇ: SDBY nedeni ile HD'e giren hastalarda acil servise başvuru oranı hastanemiz çevresinde ciddi oranda yüksektir. Acil HD'e alınan hastalarda kateter kullanımı tüm HD hastalarına göre ciddi oranda yüksektir. Rutin HD etkinliğinin değerlendirilmesi, damar erişim problemlerinin sorgulanması ve düzenli nefrolog takibi çok önemlidir. İdame diyaliz tedavisi altındaki hastaların acil HD gereksinimleri konusunda daha kapsamlı ve prospektif çalışmalara ihtiyaç bulunmaktadır.ANAhTAR SÖzcükLER: Son dönem böbrek yetmezliği, Hemodiyaliz, Arteriyovenöz fistül, Hemodiyaliz yeterliliği AbSTRAcT ObJEcTIVE: Receiving urgent hemodialysis (HD) in end-stage renal disease (ESRD) patients significantly increases morbidity and mortality. We aimed to explore the factors involved in the development of urgent hemodialysis in patients on maintenance HD and to compare clinical differences between patients with arteriovenous fistula (AVF) and permanent tunelled catheter. MATERIAL and METhODS:We retrospectively studied 242 ESRD patients over 18 years old who required urgent hemodialysis after presentation to the emergency department between November 2013 and November 2015. We excluded referrals from another hospital, drug overdose or toxic substance intake and patients in the intensive care unit. RESULTS:We analyzed retrospective (2013)(2014)(2015) data obtained ...

show abstract

Hypertension in Hemodialysis Patients: An Opinion‐Based Update

Cited by 13 publications

References 76 publications

Secondary Hyperparathyroidism and Hypertension: An Intriguing Couple

Secondary Hyperparathyroidism and Hypertension: An Intriguing Couple

Troponin I and NT-proBNP and the Association of Systolic Blood Pressure With Outcomes in Incident Hemodialysis Patients: The Choices for Healthy Outcomes in Caring for ESRD (CHOICE) Study

Evaluation of Urgent Hemodialysis in Maintenance Hemodialysis Patients: A 2-Year Retrospective Single Center Study

Contact Info

Product

Resources

About