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REVIEW
Opublikowany online: 2017-10-19
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Pathogenesis and treatment of hypertension in haemodialysis patients with chronic kidney disease

Patrycja Pokora, Marcin Adamczak, Andrzej Więcek
DOI: 10.5603/AH.a2017.0021

dostęp otwarty

Ahead of print
REVIEW
Opublikowany online: 2017-10-19

Streszczenie

Hypertension is frequently diagnosed among patients with chronic kidney disease (CKD) and often remains poorly controlled in end stage kidney disease (ESKD) especially in haemodialysis patients. These patients are characterized by higher blood pressure variability than the general population. Volume overload is a primary factor contributing into the pathogenesis of hypertension in this cohort. In the diagnosis, treatment and monitoring of hypertension in haemodialysis patients with chronic kidney disease self-measured of blood pressure at home done during the days between haemodialysis sessions should be considered. Home blood pressure measurements are of greater prognostic value than haemodialysis unit recording. Target-values of blood pressure in haemodialysis patients are still matter of debate. However, self-measured systolic blood pressure values at home between 120 to 130 mmHg are associated with the best prognosis in haemodialysis patients with CKD. Among not pharmacological methods of antihypertensive treatment in haemodialysis patients with CKD reducing volaemia by increasing ultrafiltration during haemodialysis procedures, individualization of sodium concentration in the dialysis fluid and low sodium diet should be listed. While, in the pharmacotherapy β-adrenergic antagonists seems to be the drugs of first choice.

Streszczenie

Hypertension is frequently diagnosed among patients with chronic kidney disease (CKD) and often remains poorly controlled in end stage kidney disease (ESKD) especially in haemodialysis patients. These patients are characterized by higher blood pressure variability than the general population. Volume overload is a primary factor contributing into the pathogenesis of hypertension in this cohort. In the diagnosis, treatment and monitoring of hypertension in haemodialysis patients with chronic kidney disease self-measured of blood pressure at home done during the days between haemodialysis sessions should be considered. Home blood pressure measurements are of greater prognostic value than haemodialysis unit recording. Target-values of blood pressure in haemodialysis patients are still matter of debate. However, self-measured systolic blood pressure values at home between 120 to 130 mmHg are associated with the best prognosis in haemodialysis patients with CKD. Among not pharmacological methods of antihypertensive treatment in haemodialysis patients with CKD reducing volaemia by increasing ultrafiltration during haemodialysis procedures, individualization of sodium concentration in the dialysis fluid and low sodium diet should be listed. While, in the pharmacotherapy β-adrenergic antagonists seems to be the drugs of first choice.

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Słowa kluczowe

hypertension; haemodialysis; chronic kidney disease

Informacje o artykule
Tytuł

Pathogenesis and treatment of hypertension in haemodialysis patients with chronic kidney disease

Czasopismo

Arterial Hypertension

Numer

Ahead of print

Data publikacji on-line

2017-10-19

DOI

10.5603/AH.a2017.0021

Słowa kluczowe

hypertension
haemodialysis
chronic kidney disease

Autorzy

Patrycja Pokora
Marcin Adamczak
Andrzej Więcek

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