| Theme |
The consideration of polypharmacy in dialysis patients |
| Title |
Treatment for hypertension and arrhythmia in dialysis patients |
| Author |
Hiromichi Wakui |
Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine |
| Author |
Kazushi Uneda |
Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine |
| Author |
Kouichi Tamura |
Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine |
| [ Summary ] |
In dialysis patients, blood pressure should be evaluated not only in the dialysis room but also at home. In patients under stable long-term maintenance dialysis with no impairment of cardiac function, the target of antihypertensive treatment should be blood pressure < 140/90 mmHg before dialysis at the beginning of the week. Dry weight (DW) should be appropriately established when determining the target blood pressure. Antihypertensive agents should be administered when the reduction in blood pressure is inadequate, even after achievement/maintenance of DW. Because dialysis patients with arrhythmias are likely to have organic heart diseases, physicians should perform echocardiography and, when necessary, coronary angiography. In addition, warfarin should not be used in the treatment of atrial fibrillation without careful evaluation. |