Author/Editor		Urbančič, Alenka
Title		Hypertension in chronic dialysis patients
Type		članek
Source		In: Buturović-Ponikvar J, Bren AF, editors. Zbornik 2. slovenski nefrološki kongres z mednarodno udeležbo ob 30. letnici dialize in transplantacije ledvic v Sloveniji; 2000 sep 27-30; Brdo pri Kranju. Ljubljana: Klinični center, Klinični oddelek za nefrologijo,
Publication year		2000
Volume		str. 95-100
Language		eng
Abstract		Hypertension is a very common cause and the consequence of renal failure. It is present in almost 100 % of patients with preterminal renal insufficiency and in up to 60 % among chronic hemodialysis (CHID) patients. Hypertension is the main reason for the development of left ventricular hypertrophy (LVH) which is an independent predictor of cardiovascular mortality in CHID patients. Cardiovascular events are the main cause of mortality in CHID patients. Hypervolemia and sodium retention play the main role in the development of hypertension. Increased vascular resistance and/or increased cardiac output due to hypervolemia lead to hypertension. A tendency of increased vascular resistance is due to impaired vascular structure, inap propriate activation of pressure systems, inappropriate suppression of pressure systems and due to combination of them. The mechanisms are activation of sympaticus, renin - angiotensin system, endothelin and other vasoconstrictor substances, NO and other vasodepressor substances, abnormal ionic channels. Some CHID patients are hypertensive in normovolemic state and need medication for blood pressure regulation and more strict control of volemia and sodium intake. In some patients long term hypertension and/or hypervolemia lead to vascular unresponsiveness to therapy. It is therefore obvious to reduce sodium and water retention in CHID and chronic renal failure patients to reduce hypertension and LVH related morbidity and mortality.
Descriptors		HYPERTENSION HEMODIALYSIS, HOME KIDNEY FAILURE, CHRONIC