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)*

Détails

ID Serval
serval:BIB_5CEC42C65CC0
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
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)*
Périodique
Journal of Hypertension
Auteur(s)
Sarafidis Pantelis A., Persu Alexandre, Agarwal Rajiv, Burnier Michel, de Leeuw Peter, Ferro Charles, Halimi Jean-Michel, Heine Gunnar, Jadoul Michel, Jarraya Faical, Kanbay Mehmet, Mallamaci Francesca, Mark Patrick B., Ortiz Alberto, Parati Gianfranco, Pontremoli Roberto, Rossignol Patrick, Ruilope Luis, Van der Niepen Patricia, Vanholder Raymond, Verhaar Marianne C., Wiecek Andrzej, Wuerzner Gregoire, London Gérard M., Zoccali Carmine
ISSN
0263-6352
ISSN-L
0263-6352
Statut éditorial
Publié
Date de publication
04/2017
Peer-reviewed
Oui
Volume
35
Numéro
4
Pages
657-676
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
In patients with end-stage renal disease treated with hemodialysis or peritoneal dialysis, hypertension is very common and often poorly controlled. Blood pressure (BP) recordings obtained before or after hemodialysis display a J-shaped or U-shaped association with cardiovascular events and survival, but this most likely reflects the low accuracy of these measurements and the peculiar hemodynamic setting related with dialysis treatment. Elevated BP 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 apnea and the use of erythropoietin-stimulating agents may also be involved. Nonpharmacologic interventions targeting sodium and volume excess are fundamental for hypertension control in this population. If BP remains elevated after appropriate treatment of sodium-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.
Mots-clé
Internal Medicine, Physiology, Cardiology and Cardiovascular Medicine
Pubmed
Web of science
Création de la notice
14/02/2017 12:23
Dernière modification de la notice
05/06/2020 6:20
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