Abstract:
:The majority of end-stage renal disease (ESRD) patients are hypertensive. Drug therapy for hypertension in hemodialysis (HD) patients includes all classes of antihypertensive drugs, with the sole exception of diuretics. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers may decrease morbidity and mortality by reducing the mean arterial pressure (MAP), aortic pulse wave velocity, and aortic systolic pressure augmentation, as well as left ventricular hypertrophy (LVH) and probably reduction of C-reactive protein (CRP) and oxidant stress. Potential risk factors include hyperkalemia, anaphylactoid reaction with AN69 membranes (particularly ACE inhibitors), and aggravation of renal anemia. beta-blockers decrease not only mortality, blood pressure (BP), and ventricular arrhythmias, but also improve left ventricular function in ESRD patients. Nonselective beta-blockers can cause an increase in serum potassium (particularly during fasting or exercise). Lisinopril and atenolol have a predominant renal excretion and therefore a prolonged half life in ESRD patients. Thus thrice-weekly supervised administration of these drugs after HD can enhance BP control. The use of calcium channel blockers is also associated with lower total and cardiovascular-specific mortality in HD patients. Minoxidil is a very potent vasodilator that is generally reserved for dialysis patients with severe hypertension. Hypertensive dialysis patients who are noncompliant with their medications may benefit from transdermal clonidine therapy once a week. The majority of dialysis patients need a combination of several antihypertensive drugs for adequate BP control.
journal_name
Semin Dialjournal_title
Seminars in dialysisauthors
Hörl MP,Hörl WHdoi
10.1111/j.0894-0959.2004.17329.xsubject
Has Abstractpub_date
2004-07-01 00:00:00pages
288-94issue
4eissn
0894-0959issn
1525-139Xpii
SDI17329journal_volume
17pub_type
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journal_title:Seminars in dialysis
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journal_title:Seminars in dialysis
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journal_title:Seminars in dialysis
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journal_title:Seminars in dialysis
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journal_title:Seminars in dialysis
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
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journal_title:Seminars in dialysis
pub_type: 社论
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更新日期:2011-01-01 00:00:00
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journal_title:Seminars in dialysis
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journal_title:Seminars in dialysis
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
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更新日期:2001-11-01 00:00:00
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journal_title:Seminars in dialysis
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journal_title:Seminars in dialysis
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journal_title:Seminars in dialysis
pub_type: 评论,社论
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更新日期:2003-01-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
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journal_title:Seminars in dialysis
pub_type: 杂志文章
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journal_title:Seminars in dialysis
pub_type: 杂志文章
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更新日期:2016-03-01 00:00:00
abstract::In addition to extracorporeal renal replacement strategies, which in chronic kidney disease (CKD) are largely reserved for the treatment of end-stage kidney failure, conservative measures can be taken to reduce concentration, effects, or both concentration and effects of uremic retention solutes. In this overview, we ...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2009.00600.x
更新日期:2009-07-01 00:00:00
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更新日期:2020-11-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 社论
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更新日期:2002-01-01 00:00:00
abstract::There is clear evidence that survival rates following transplantation far exceed those for remaining on dialysis, regardless of body size measured by body mass index (BMI). Studies over the past 15 years also suggest little to no difference in long-term outcomes, including graft survival and mortality, irrespective of...
journal_title:Seminars in dialysis
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更新日期:2019-05-01 00:00:00