Management of hypertension in patients with end-stage renal disease leading to haemodialysis: a challenge
DOI:
https://doi.org/10.18203/2349-3933.ijam20163715Keywords:
Antihypertensives, ESRD, HemodialysisAbstract
The majority of the patients of end-stage renal disease (ESRD) leading to haemodialysis suffer from hypertension. Increase in blood pressure is both a cause and a consequence of chronic kidney disease and inadequate control of blood pressure in these patients increases the risk of development of left ventricular hypertrophy, congestive heart failure, stroke and other cardiovascular and neurological complications leading to high morbidity and mortality in these patients. In a meta-analysis of randomized controlled trials of antihypertensive therapy in haemodialysis patients, blood pressure lowering treatment was associated with a 29% lower relative risk of cardiovascular mortality and a 20% lower relative risk of all-cause mortality. While blood pressure control may improve cardiovascular mortality and morbidity, the management of hypertension is a big challenge in these patients especially in developing countries like India where the maintenance of optimal dry weight in between the dialysis therapy is inadequate due to high cost of hemodialysis and limited number of centers providing dialysis therapy. The aim of the present review the evidence on the optimal systolic and diastolic blood pressure in the patients on haemodialysis and the most effective drug or group of drugs that can provide adequate blood pressure control in all phases of dialysis (pre, post, intra and interdialytic phases) without complications like intradialytic hypotension or hypertension and good patient compliance.
References
Charra B, Calemard E, Ruffet M. Surviva as an index of adequacy of dialysis. Kidney Int. 1992;41:1286-91.
G. Laurent. How to keep the dialysis patients normotensive? What is the secret of Tassin? Nephrol Dial Transplant. 1997;12:1104.
Heerspink HJ, Ninomiya T, Zoungas S. Effect of lowering blood pressure on cardiovascular events and mortality in patients on dialysis: a systematic review and meta-analysis of randomized controlled trials. Lancet. 2009;373:1009-15.
Mailloux LU, Haley WE. Hypertension in the ESRD patients: pathophysiology, therapy, outcomes and future direction. Am J Kidney Dis. 1998;32:705-19.
Agarwal R, Nissenson AR, Battle D. Prevalence, treatment and control of hypertension in chronic haemodialysis patients in the United States. Am J Med. 2003;115:291-7.
Rahman M, Griffin V, Kumar A, Manzoor F. A comparison of standardized versus “usual” blood pressure measurments in haemodialysis patients. Am J Kidney Dis. 2002;39:1226-30.
Neaton JD, Kuller L, Stamler J. Impact of systolic and diastolic blood pressure on cardiovascular mortality. Diagnosis, and Management. 2 ed. New York: Raven Press. 1995;127:144.
Alborzi. Home blood pressure monitoring is of greater prognostic value than haemodialysis units recordings. CJASN. 2007;2:1228-34.
Luther JM. Relationship between BP and mortality in dialysis patients. Kidn Int. 2008;73:667-8.
Inrig JK, Oddone EZ, Hasselblad. Association of intradialytic blood pressure changes with hospitalization and mortality rates in prevalent ESRD patients. Kidney Int. 2007;71:454-61.
Shoji T, Tsubakihara Y, Fujii M, Imai E: Hemodialysis-associated hypotension as an independent risk factor for two-year mortality in hemodialysis patients. Kidney Int. 2004;66:1212-20.
Huerta C, Castellsaque J, Varas C, Garcia LA: Nonsteroidal anti-inflammatory drugs and risk of ARF in the general population. Am J Kidney Dis. 2005;45(3):531-9.
Davenport. Patients achieving pre- and post-dialysis UK RA blood pressure targets. Kidney International. 2008;73:759-4.
Kalantar-Zadeh. Association between BP and 15-month CV death in MHD patients. Hypertension. 2005;45:811-7.
Agarwal R. Hypertension in chronic kidney disease and dialysis: Pathophysiology and management. Cardiol Clin. 2005;23:237-48.
De Paula FM, Peixoto AJ, Pinto LV. Clinical consequences of an individualized dialysate sodium prescription in haemodialysis patients. Kidney Int. 2004;66:1232-8.
Nephrol Dial Transplant. Mechanism of HTN. 2004;19(5):1058-68.
Foley RN, Herzog CA, Collins AJ. Smoking and cardiovascular outcome in dialysis patients. Kidney Int. 2003;63(4):1462-7.
Agarwal R. hypertension. 2009;53(3);500-7.
Am J Kidney Dis. Mechanism of Hypertension. 1996;28(2):257-61.
He FJ, MacGregor GA. Effect of modest salt reduction on blood pressure: A meta-analysis of randomized trial. Implications for public health. J Hum Hypertens. 2002;16:761-70.
Agarwal R. Hypertension. 2009;53(3):500-7.
Efrati S, Zaidenstein R, Dishy V, Beberashvili, Weissgarten J. ACE inhibitors and survival of haemodialysis patients. Am J Kidney Dis. 2002;40:1023-9.
Kestenbaum B, Gillen DL, Sherrard DJ: Calcium channel blocker use and mortality among patient with end-stage renal disease. Kidney Int. 2002;61:2157-64.
Folyy RN, Herzog CA, Collins AJ. Blood pressure and long term mortality in United States haemodialysis patients: USRDS Waves 3 and 4 study. Kidney Int. 2002;62:1784-90.
Suzuki H. Am J Kidney Dis. 2008;52(3):501-6.
Mastermoto N, Ishimitsu T, Okamura A. Effects of imidapril on left ventricular mass in chronic haemodialysis patients. Hypertens Res. 2006;29:253-60.
Berger AK, Duval S, Krumhol HM. Aspirin, beta-blocker and angiotensin converting enzyme inhibitor therapy in patients with end-stage renal disease and an acute myocardial infarction. J Am Coll Cardiol. 2003;42:201-8.
Pun Ph, Lehrich RW, Smith SR. predictors of survival after cardiac arrest in outpatient haemodialysis clinic. Clin J Am Soc Nephrol. 2007;2:491-500.
Agarwar R, Sinha AD, Pappas MK, Abraham TN. Hypertension in haemodialysis patients treated with Atenolol or Lisinopril. A randomized controlled trial. Nephrol Dial Transplant. 2014;(3):672-81.
Moist LM, Port FK, Orzol SM. Predictor of loss of residual renal function among new dialysis patients. J Am Soc Nephrol. 2000;11:556-64.
Knoll G, Sahgal A, Nair RC. Renin-angiotensin system blockade and risk of hyperkalemia in chronic haemodialysis patients. Am J Med. 2002;112:11-4.
Han Sw and Won YW. No impact of hyperkalemia with renin-angiotensin system blockades in maintenance haemodialysis patient. Nephrol Dial Transplant. 2007;22:1150-5.
Tepel M, Van der Giet M, Zidek W. Efficacy and tolerability of angiotensin II type-I receptor antagonists in dialysis patients using AN69 dialysis membranes. Kidney Blood Press Res. 2001;24:71-4.
Takahashi A, Takase H, Toriyama. Candisartan, an angiotensin II type-1 receptor blocker, reduces cardiovascular events in patients on chronic haemodialysis -a randomized study. Nephrol Dial Transplant. 2006;21:2507-12.
Asla S, Santha T, Leoni A, Wilcox C. Effect of Amlodipine and Valsartan on oxidative stress and plasma methylarginines in end-stage renal disease patients on haemodialysis : Kidney International. 2006;70:2109-15.
Ichihara A, Hayashi M, Kanisitro Y. Low doses of Losartan and Trandolapril improved arterial stiffness in haemodialysis patients. Am J Kidney Dis. 2005;45:866-74.
Suzuki. Enalapril and Losartan lead to regression of left ventricular hypertrophy in haemodialysis patients Ther Apheresis and Dialysis. 2004;4:320-7.
Winkelmeyer. ACE Inhibitors after cardiac events in patients on Haemodialysis . Am J Kidney Dis. 2005;47:301-8.
Agarwal R, Nissenson AR, Battle D. prevalence treatment and control of hypertension in chronic haemodialysis patient in the United States. Am J Med. 2003;115:291-7.
Kungys G, Naujoks H, Wanner C. Pharmacokinetics of Amlodipine in hypertensive patients undergoing haemodialysis . Eur J Clin Pharmacol. 2003;59:291-5.
Zachariah PK, Moyer TP, Theobald. The pharmacokinetics of racemic verapamil in patients with impaired renal function. J Clin Pharmacol. 1991;31:45-53.
Satosker RS, Nirmala NR, Bhardarkar SD. Pharmacology and pharmacotherapeutics 24th edition. 2015;406-7.
Tepel M, Hopfenmueller W, Scholze A, Maler A. Effect of Amlodipine on cardiovascular events in hypertensive haemodialysis patients. Nephrol Dial Transplant. 2008;23:2605-3612.
Kestenbaun B, Gillen DL, Sherrard. Calcium channel blocker use and mortality among patients with end-stage renal disease. Kidney Int. 2002;61:2157-64.
Tepel M, Giet MV, Park A. Association of calcium channel blockers and mortality in haemodialysis patient. Clin Sci (Lond). 2002;103:511-5.
London GM, Pannier B, Guerin AP. Cardiac hypertrophy, aortic compliance, peripheral resistance and wave reflection in end-stage renal disease. Comparative effects of ACE inhibition and calcium channel blockade. Circulation. 1994;90:2786-96.
Doyle GD, Donohue J, Carmody M, Laher M. Pharmacokinetics of amlodipine in renal impairment. Eur J Clin Pharmacol. 1989;36(2):205-8.
Whelton PK, Watson AJ, Kone B. Calcium channel blockade in dialysis patients with left ventricular hypertrophy and well-preserved systolic function, J Cardiov Pharmacol. 1987;10:185-7.
Zoccali C, Mallamaci F, Parlongo S. Plasma norepinephrine predicts survival and incident cardiovascular events in patients with end-stage renal disease. Circulation. 2002;105:1354-9.
Epstein M, Oster JR. Beta blockers and renal function: a reappraisal. J Clin Hypertens. 1985;1:85-99.
Sugino G, Barg AP. Renal perfusion is preserved during cardioselective beta-blockade with metoprolol in hypertension. Am J Kidney Dis. 1984;3:357-61.
Ljungman S, Wikstrand J. Effects of long-term antihypertensive treatment and aging on renal function and albumin excretion in primary hypertension. Am J Hypertens. 1993;6:554-63.
Seiler KU, Schuster KJ. The pharmacokinetics of metoprolol and its metabolites in dialysis patients. Clin Pharmacokinet. 1980;5:192-8.
Branten AJ, Hilbrands LB, Van Hamersvelt HW. Renal and systemic effects of atenolol and tertalol in renal transplant recipients on cyclosporine. Nephrol Dial Transplant. 1998;13:423-6.
Agarwal R. Supervised atenolol therapy in the management of haemodialysis hypertension. Kidney Int. 1999;55:1528-35.
Cice. Carvedilol increases two year survival in dialysis patients with dilated cardiomyopathy: JACC. 2003;41:1438-44.
Rosansky SJ, Johnson KL, Mc Connel J. Use of transdermal clonidine in chronic haemodialysis patients. Clin Nephrol. 1993;39:32-6.
Bartam G, Katzung, Anthony J. Trevor: Basic and clinical pharmacology. 13th Edition; 2015:269-299.
Campese VM, Stein D, De Quattro V. Treatment of severe hypertension with minoxidil: advantages and limitations. J Clin Pharmacol. 1979;19:231-2.
Henrich W. Principles and Practice of Dialysis. 12th Edition; 2009:1121-1145.