| Theme | Points of dietary therapy for national registered dietitian to establish clinical guideline for nutrition in dialysis patients | |
|---|---|---|
| Title | Management of resistant hypertension in hemodialysis patients | |
| Publish Date | 2012/11 | |
| Author | Masaki Fukushima | Department of Internal Medicine, Shigei Medical Research Hospital |
| Author | Toshie Araki | Department of Internal Medicine, Shigei Medical Research Hospital |
| Author | Toru Ichimura | Department of Internal Medicine, Shigei Medical Research Hospital |
| Author | Junko Kurozumi | Department of Nutrition Management, Shigei Medical Research Hospital |
| [ Summary ] | Since the main cause of hypertension in hemodialysis patients is increased extracellular volume, salt restriction and removal of excess fluids through hemodialysis are the first steps for blood pressure control. Anuric hemodialysis patients generally ingest approximately 1 l of water for every 8 g of salt intake. It is recommended all hemodialysis patients restrict salt intake to less than 6 g/day, and maintain interdialytic weight gain at 3-5 % or less of dry weight. In patients with extreme dry weight, however, this level of weight gain may lead to an excess intake of salt. In addition, low salt diets may result in malnutrition, causing resistant hypertension due to fluid retention. Periodic evaluation of dry weight and nutritional status as well as salt restriction is essential to manage hypertension in hemodialysis patients. | |