| [ Summary ] |
Few clinical studies have shown evidence level information regarding hypertension in patients on chronic hemodialysis. The target blood pressure levels for hemodialysis patients should be below 140 / 90 mmHg before dialysis as well as during the interdialysis period, and below 130 / 80 mmHg after dialysis, only when patients have neither intradialytic hypotension nor orthostatic hypotension. Blood pressure should be measured when the patients wake up in the morning, just before sleeping, and when patients have symptoms such as headache or nausea, which may be signs of hypertension, as well as while undergoing dialysis. Antihypertensive agents may be employed. Firstly, angiogenesis receptor blockers may be used along with, angiogenesin converting enzyme inhibitors, or calcium channel blockers. Next, β blockers or α1 blockers may be employed. Central sympatho-inhibitory drugs, and lastly direct vasodilators may be used when patients cannot obtain enough blood pressure control by using the above drugs. When anti-hypertensive agents are prescribed for dialysis patients, consideration must be made for the removal of drugs during dialysis, the durability of anti-hypertensive effects, and the time medications are taken. |