Hypertension in patients treated with renal replacement therapy

Abstract

Background Hypertension is an important risk factor for morbidity and mortality in patients with chronic kidney diseases. The aim of the study was to assess prevalence of hypertension in patients on renal replacement therapy
Material and methods The studies were performed on 174 dialyzed patients and 101 kidney allograft recipients.
Results Hypertension was most prevalent in kidney allograft recipients (84.7%). In the population of dialyzed patients, 2.3 of peritoneally dialyzed patients were hypertensive, whereas 50% of hemodialyzed patients were hypertensive. Blood pressure values were significantly higher in kidney allograft recipients when compared to dialyzed patients. In peritoneally dialyzed patients most commonly used hypotensive drugs were b-blockers (77%). In dialyzed patients ACE inhibitors were used significantly more often than in kidney allograft recipients. In patients after kidney transplantation the most commonly used hypotensive drugs were calcium channel blockers. In hemodialyzed patients coronary artery disease was more common in hypertensive patients in contrast to peritoneally dialyzed patients. In kidney allograft recipients coronary artery disease was similarly prevalent in hypertensive and normotensive patients.
Conclusions Hypertension is very common in patients on renal replacement therapy and is affected by the type of the therapy (dialysis vs renal transplantation). Moreover, hypertension is not adequately controlled and renoprotective drugs i.e. ACE inhibitors are underutilized in patients on renal replacement therapy. Coronary artery disease in hypertensive patients on renal replacement therapy is an important risk factor for cardiovascular complication in this vulnerable population.