Hypertension in Dialysis Patients: Diagnostic Approaches and Evaluation of Epidemiology

Whereas hypertension is an established cardiovascular risk factor in the general population, the contribution of increased blood pressure (BP) to the huge burden of cardiovascular morbidity and mortality in patients receiving dialysis continues to be debated. In a large part, this controversy is att...

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Published inDiagnostics (Basel) Vol. 12; no. 12; p. 2961
Main Authors Georgianos, Panagiotis I, Vaios, Vasilios, Sgouropoulou, Vasiliki, Eleftheriadis, Theodoros, Tsalikakis, Dimitrios G, Liakopoulos, Vassilios
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 26.11.2022
MDPI
Subjects
Accuracy
ambulatory BP monitoring
Blood pressure
Care and treatment
Clinical trials
Complications and side effects
Diagnosis
dialysis
Epidemiology
Hemodialysis
home BP monitoring
Hypertension
Kidney diseases
Mortality
Peritoneal dialysis
Review
Risk factors
Greece
dialysis
epidemiology
diagnosis
hypertension
home BP monitoring
ambulatory BP monitoring
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Summary:Whereas hypertension is an established cardiovascular risk factor in the general population, the contribution of increased blood pressure (BP) to the huge burden of cardiovascular morbidity and mortality in patients receiving dialysis continues to be debated. In a large part, this controversy is attributable to particular difficulties in the accurate diagnosis of hypertension. The reverse epidemiology of hypertension in dialysis patients is based on evidence from large cohort studies showing that routine predialysis or postdialysis BP measurements exhibit a U-shaped or J-shaped association with cardiovascular or all-cause mortality. However, substantial evidence supports the notion that home or ambulatory BP measurements are superior to dialysis-unit BP recordings in diagnosing hypertension, in detecting evidence of target-organ damage and in prognosticating the all-cause death risk. In the first part of this article, we explore the accuracy of different methods of BP measurement in diagnosing hypertension among patients on dialysis. In the second part, we describe how the epidemiology of hypertension is modified when the assessment of BP is based on dialysis-unit versus home or ambulatory recordings.
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ISSN:2075-4418
2075-4418
DOI:10.3390/diagnostics12122961