title: [Prevalence and control of hypertension in chronic hemodialysis patients: results of a single-centre clinical audit].
abstract: Hypertension (HTN) is very common in chronic hemodialysis patients, with a prevalence of 72%, a very poor control and an annual mortality of 23%. We report the results of a clinical audit on prevalence and control of HTN in our hemodialysis patients. The following parameters in a cohort of 89 patients were assessed in one-month observational study, conducted in October 2010: blood pressure (BP) before the beginning (preHD BP) and after the end of the treatment (postHD BP), age, sex, comorbidity, serum hemoglobin (Hb) levels, plasma and dialysate sodium levels, interdialytic weight gain (IWG), serum parathyroid hormone (PTH) levels, prescription of erythropoiesis stimulating agents (ESA) and of antihypertensive drugs. In agreeement to the current guidelines, patients with preHD BP ≤140/90 mmHg and postHD BP ≤130/80 mmHg were considered normortensive. Forty-nine patients (55%) were found to be hypertensive. The following comorbidities, graded as 1+ to 3+, were detected: ischemic/hypertrophic cardiopathy, dyslipidemia, peripheral arteriopathy, diabetes mellitus. Only 14.3% of patients achieved both preHD and postHD BP targets. Compared to patients whose BP was not controlled, those achieving BP targets were younger, had lower dialysate sodium levels and showed a greater IWG. No significant difference there was in serum Hb levels, plasma sodium levels, serum PTH levels, prescription of antihypertensive drugs and ESA. Our data confirm the high prevalence of HTN and the unsatisfactory BP control in hemodialysis patients. A low-salt diet, probing for dry-weight and the antihypertensive medication may help to achieve the BP control.
authors.affiliation: IRCCS Casa Sollievo della Sofferenza, Struttura Complessa di Nefrologia e Dialisi, San Giovanni Rotondo (FG), Italy. a.delgiudice@operapadrepio.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Del Giudice
authors.forename: Antonio
authors.initials: A
authors.lastname: Cicchella
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Giorgio
authors.forename: Matteo
authors.initials: M
authors.lastname: Piemontese
authors.forename: Michele
authors.initials: M
authors.lastname: Prencipe
authors.forename: Andrea
authors.initials: A
authors.lastname: Fontana
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Copetti
authors.forename: Fabio
authors.initials: F
authors.lastname: Pellegrini
authors.forename: Filippo
authors.initials: F
authors.lastname: Aucella
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology*; D015995:Prevalence; D006435:Renal Dialysis
chemical_list: D000959:Antihypertensive Agents