Hypertension in end-stage kidney disease

Abstract

is complex and involves several mechanisms of intrinsic vascular control, volume status, and sodium loading [Figure 1]. One of the primary mechanisms responsible for hypertension in ESKD patients is volume overload beyond Abstract Hypertension remains a leading etiology of end-stage kidney disease. The disease has a complex pathophysiology and contributes to a wide array of morbidities and mortality for patients across the globe. Due to the lack of published data on the subject, diagnosing and monitoring hypertension in the dialysis population poses a great challenge, as currently there are no published blood pressure target goals and in-center monitoring is often not reliable. Moreover, the management of this condition involves conservative approaches for both adjusting dialysis prescriptions and limiting dietary fluid and sodium intake. Therapy is often escalated with pharmacologic agents, of which emerging data suggest that it may be useful to use certain drug classes initially. However, professional guidelines do not provide specific drug therapy recommendations at this time.