Blood Pressure Control in Chronic Hemodialysis Patients

  • Gérard London
  • S. Marchais
  • A. P. Guerin


Cardiovascular complications are the leading cause of mortality and morbidity in the population of end-stage renal disease (ESRD) patients on renal replacement therapy (1). Hypertension, either as a primary cause, or consequence of renal failure, is a major risk factor contributing to the high cardiovascular morbidity and mortality in uremic patients and has been found in approximately 80% of patients developing ESRD (2, 3). The prevalence of hypertension in ESRD varies somewhat according to the different etiologies of renal failure. Patients with glomerulonephritis, diseases involving small vessels (vasculitis, scleroderma) or diabetic nephropathy have hypertension more often than those with tubulointerstitial disease (4). Once dialysis is begun, 5 to 50% remain hypertensive on the basis of casual blood pressure (BP) measurements (5). Continuous BP monitoring has shown that the proportion of ESRD patients with uncontrolled hypertension is much higher than that whose BP is adequately controlled (85 versus 15%) (6). Hypertension increases the severity and incidence of left ventricular hypertrophy (LVH) (7, 8) and atherosclerosis (9), implying that the treatment of hypertension and the maintenance of a normal BP are mandatory in ESRD patients


Dialysis Patient Atrial Natriuretic Peptide ESRD Patient Total Peripheral Resistance Recombinant Human Erythropoietin 
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Copyright information

© Kluwer Academic Publishers 1996

Authors and Affiliations

  • Gérard London
    • 1
  • S. Marchais
    • 1
  • A. P. Guerin
    • 1
  1. 1.Nephrology and Hemodialysis DepartmentCenter Hospitalier ManhèsFleury MérogisFrance

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