Hypertension in dialysis patients: a consensus document by the European Renal and Cardiovascular Medicine (EURECA-m) working group of the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) and the Hypertension and the Kidney working group of the European Society of Hypertension (ESH).

Details

Serval ID
serval:BIB_323A4D0E5076
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Hypertension in dialysis patients: a consensus document by the European Renal and Cardiovascular Medicine (EURECA-m) working group of the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) and the Hypertension and the Kidney working group of the European Society of Hypertension (ESH).
Journal
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
Author(s)
Sarafidis P.A., Persu A., Agarwal R., Burnier M., de Leeuw P., Ferro C.J., Halimi J.M., Heine G.H., Jadoul M., Jarraya F., Kanbay M., Mallamaci F., Mark P.B., Ortiz A., Parati G., Pontremoli R., Rossignol P., Ruilope L., Van der Niepen P., Vanholder R., Verhaar M.C., Wiecek A., Wuerzner G., London G.M., Zoccali C.
ISSN
1460-2385 (Electronic)
ISSN-L
0931-0509
Publication state
Published
Issued date
01/04/2017
Peer-reviewed
Oui
Volume
32
Number
4
Pages
620-640
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
In patients with end-stage renal disease (ESRD) treated with haemodialysis or peritoneal dialysis, hypertension is common and often poorly controlled. Blood pressure (BP) recordings obtained before or after haemodialysis display a J- or U-shaped association with cardiovascular events and survival, but this most likely reflects the low accuracy of these measurements and the peculiar haemodynamic setting related to dialysis treatment. Elevated BP detected by home or ambulatory BP monitoring is clearly associated with shorter survival. Sodium and volume excess is the prominent mechanism of hypertension in dialysis patients, but other pathways, such as arterial stiffness, activation of the renin-angiotensin-aldosterone and sympathetic nervous systems, endothelial dysfunction, sleep apnoea and the use of erythropoietin-stimulating agents may also be involved. Non-pharmacologic interventions targeting sodium and volume excess are fundamental for hypertension control in this population. If BP remains elevated after appropriate treatment of sodium and volume excess, the use of antihypertensive agents is necessary. Drug treatment in the dialysis population should take into consideration the patient's comorbidities and specific characteristics of each agent, such as dialysability. This document is an overview of the diagnosis, epidemiology, pathogenesis and treatment of hypertension in patients on dialysis, aiming to offer the renal physician practical recommendations based on current knowledge and expert opinion and to highlight areas for future research.

Pubmed
Web of science
Open Access
Yes
Create date
04/04/2017 18:13
Last modification date
20/08/2019 13:17
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