Uncertainties in BP management in dialysis patients

Doulton, Timothy; Swift, Pauline A.; Murtaza, Asam; Dasgupta, Indranil

doi:10.1111/sdi.12880

Cited by 8 publications

(5 citation statements)

References 154 publications

(206 reference statements)

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“…Many studies have consistently shown a J-shaped relationship between mortality and lowest and highest BP in CKD G5D patients [ 32 ]. This relationship also applies to PD patients, without exception [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Association of blood pressure after peritoneal dialysis initiation with the decline rate of residual kidney function in newly-initiated peritoneal dialysis patients

Kuroki

Hori²,

Tsuruya

et al. 2021

PLoS ONE

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Background Lower blood pressure (BP) levels are linked to a slower decline of kidney function in patients with chronic kidney disease (CKD) without kidney replacement therapy. However, there are limited data on this relation in peritoneal dialysis (PD) patients. Here we evaluated the association of BP levels with the decline of residual kidney function (RKF) in a retrospective cohort study. Methods We enrolled 228 patients whose PD was initiated between 1998 and 2014. RKF was measured as the average of creatinine and urea clearance in 24-hr urine collections. We calculated the annual decline rate of RKF by determining the regression line for individual patients. RKF is thought to decline exponentially, and thus we also calculated the annual decline rate of logarithmic scale of RKF (log RKF). We categorized the patients’ BP levels at 3 months after PD initiation (BP3M) into four groups (Optimal, Normal & High normal, Grade 1 hypertension, Grade 2 & 3 hypertension) according to the 2018 European Society of Cardiology and European Society of Hypertension Guidelines for the management of arterial hypertension. Results The unadjusted, age- and sex-adjusted, and multivariable-adjusted decline rate of RKF and log RKF decreased significantly with higher BP3M levels (P for trend <0.01). Compared to those of the Optimal group, the multivariable-adjusted odds ratios (95% confidence interval) for the faster side of the median decline rate of RKF and log RKF were 4.04 (1.24–13.2) and 5.50 (1.58–19.2) in the Grade 2 and 3 hypertension group, respectively (p<0.05). Conclusions Higher BP levels after PD initiation are associated with a faster decline in RKF among PD patients.

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Section: Discussionmentioning

confidence: 99%

Association of blood pressure after peritoneal dialysis initiation with the decline rate of residual kidney function in newly-initiated peritoneal dialysis patients

Kuroki

Hori²,

Tsuruya

et al. 2021

PLoS ONE

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“…Beta blockers, RAAS-blocking agents, and dihydropyridine calcium channel blockers are all reasonable choices. Diuretics may be used in the patients to help fluid removal in those individuals with residual renal function 28 ( Table 1 ).…”

Section: Methodsmentioning

confidence: 99%

Management of Hypertension in Patients With Diabetic Kidney Disease: Summary of the Joint Association of British Clinical Diabetologists and UK Kidney Association (ABCD-UKKA) Guideline 2021

Banerjee

Winocour

Chowdhury

et al. 2022

Kidney International Reports

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Decreasing salt consumption leads to decreased blood pressure in the overall population, individuals with high blood pressure from all ethnic backgrounds, individuals with and without diabetes, and patients with chronic kidney disease (CKD) [38][39][40][41][42].…”

Section: Non-pharmacological Interventionmentioning

confidence: 99%

Hypertension on Dialysis Patients: Influence Factor and Management

Swastika,

Tarigan

2024

JETROMI

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Background: Hypertension remains prevalent and challenging to manage in patients with chronic kidney disease, even with renal replacement therapy. This phenomenon arises from a variety of components that contribute to and create an intricate process of interaction, which can impact the regulation of blood pressure in patients undergoing dialysis. The main goal of this overview is to find the influence factor of blood pressure in dialysis patients and investigate ways to better control their blood pressure by incorporating these factors.Methods: The literature searches using online databases such as PubMed and Google Scholar. Results: After doing an online search, we found 32 articles were relevant to this review topic. Discussion: There are additional elements that contribute to hypertension in dialysis patients, including excessive volume, heightened arterial rigidity, stimulation of the renin-angiotensin-aldosterone system, sleep apnea, activation of the sympathetic nervous system, and the administration of recombinant erythropoietin.Conclusion: Enhanced comprehension of the numerous variables at issue can effectively enhance blood pressure regulation in this group of individuals.

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Uncertainties in BP management in dialysis patients

Cited by 8 publications

References 154 publications

Association of blood pressure after peritoneal dialysis initiation with the decline rate of residual kidney function in newly-initiated peritoneal dialysis patients

Association of blood pressure after peritoneal dialysis initiation with the decline rate of residual kidney function in newly-initiated peritoneal dialysis patients

Management of Hypertension in Patients With Diabetic Kidney Disease: Summary of the Joint Association of British Clinical Diabetologists and UK Kidney Association (ABCD-UKKA) Guideline 2021

Hypertension on Dialysis Patients: Influence Factor and Management

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