| Theme | Blood Pressure Control in Chronic Renal Failure | |
|---|---|---|
| Title | Cause of hypertension and choice of antihypertensive drugs in hemodialysis patients | |
| Publish Date | 1997/09 | |
| Author | Motonobu Nishimura | Department of Internal Medicine and Division of Clinical Reseach, Sakura National Hospital |
| Author | Kenichi Yamada | Department of Internal Medicine and Division of Clinical Reseach, Sakura National Hospital |
| [ Summary ] | Cardiovascular disease is the leading cause of death in dialysis patients and high blood pressure is a major factor contributing to the high incidence of cardio vascular morbidity and mortality in dialysis patients. However, hypertension is not adequately controlled in hemodialysis patients. Retention of body fluid plays the major role in increasing blood pressure. Furthermore, increased plasma renin activity, increased sympathetic nervous system activity changes in calcium metabolism and administration of recombinant human erythropoietin also affect blood pressure. Maintaining the optimal dry weight, hematocrit and calcium metabolism is important for management of hypertension, as is the use of antihypertensive drugs. Furthermore, casual blood pressure recordings do not adequately represent the average blood pressure in hemodialysis patients. Therefore, ambulatory blood pressure monitoring is recommended for optimal management of hypertension. | |