The controversies of diagnosing and treating hypertension among hemodialysis patients.
This review discusses 10 current controversies regarding the dialysis patient with hypertension. The clinician is faced with a dilemma at the bedside on how to evaluate blood pressure and treat this condition in a patient on long-term hemodialysis. The evidence base to give firm recommendations is thin, but the epidemiological evidence tells us to do nothing. This appears to be an incorrect strategy, at least based on what we know today. Evaluating home BP in every dialysis patient, evaluating volume status on a regular basis, and treating hypertension predominantly with nonpharmacological strategies are worthwhile.
Indiana University School of Medicine and Roudebush VA Medical Center, Indianapolis, Indiana 46202, USA. ragarwal@iupui.edu
Rajiv
R
Agarwal
D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D001795:Blood Pressure Determination; D018660:Blood Pressure Monitoring, Ambulatory; D004039:Diet, Sodium-Restricted; D045604:Extracellular Fluid; D006440:Hemofiltration; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D010953:Plasma Volume; D011379:Prognosis; D006435:Renal Dialysis
D000959:Antihypertensive Agents