Hypertension in chronic dialysis patients: pathophysiology, monitoring, and treatment.
The prevalence of hypertension in the population with ESRD is very high, approaching 100% in some populations, and may account for the fact that cardiovascular disease continues to be the leading cause of morbidity and mortality in ESRD. The pathophysiology of hypertension in ESRD is reviewed, suggesting multifactorial causes; a dominant cause is that of volume expansion and an inappropriate increase in systemic vascular resistance because of activation of the renin-angiotensin system. The primary goal in the treatment of hypertension should be to attain a dry-weight and maintain volume control through limiting salt and fluid intake and ultrafiltration of excess fluids. If this approach is unsuccessful, an array of antihypertensive medications are available to help control blood pressure in patients with ESRD.
Morse
Stephen A
SA
Section of Nephrology, Department of Medicine, Louisianna State University Health Science Center, New Orleans, USA.
Dang
An
A
Thakur
Vashu
V
Zhang
Rubin
R
Reisin
Efrain
E
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000502:physiology; D015897:Comorbidity; D004730:Endothelium, Vascular / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000401:mortality*; D006435:Renal Dialysis; D012307:Risk Factors; D013564:Sympathetic Nervous System / Q000378:metabolism
D000959:Antihypertensive Agents