Although intradialytic hypertension is associated with all-cause mortality, the mechanisms that underlie this phenomenon are not well understood. Now, Nongnuch et al. report that post-dialysis hypertension is associated with extracellular fluid overload, and suggest that patients with this condition might benefit from increased dialysis session length or frequency.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Nongnuch, A. et al. Increased postdialysis systolic blood pressure is associated with extracellular overhydration in hemodialysis outpatients. Kidney Int. http://dx.doi.org/10.1038/ki.2014.276.
Inrig, J. K. et al. Association of intradialytic blood pressure changes with hospitalization and mortality rates in prevalent ESRD patients. Kidney Int. 71, 454–461 (2007).
Agarwal, R. Hypertension in chronic kidney disease and dialysis: pathophysiology and management. Cardiol. Clin. 23, 237–248 (2005).
Charra, B. et al. Survival as an index of adequacy of dialysis. Kidney Int. 41, 1286–1291 (1992).
Agarwal, R., Alborzi, P., Satyan, S. & Light, R. P. Dry-weight reduction in hypertensive hemodialysis patients (DRIP): a randomized, controlled trial. Hypertension 53, 500–507 (2009).
Curatola, G. et al. Ultrafiltration intensification in hemodialysis patients improves hypertension but increases AV fistula complications and cardiovascular events. J. Nephrol. 24, 465–473 (2011).
Moissl, U. et al. Bioimpedance-guided fluid management in hemodialysis patients. Clin. J. Am. Soc. Nephrol. 8, 1575–1582 (2013).
Mallamaci, F. et al. Detection of pulmonary congestion by chest ultrasound in dialysis patients. JACC Cardiovasc. Imaging 6, 586–594 (2010).
Converse, R. L. Jr et al. Sympathetic overactivity in patients with chronic renal failure. N. Engl. J. Med. 327, 1912–1918 (1992).
Schlaich, M. P. et al. Feasibility of catheter-based renal nerve ablation and effects on sympathetic nerve activity and blood pressure in patients with end-stage renal disease. Int. J. Cardiol. 168, 2214–2220 (2013).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing financial interests.
Rights and permissions
About this article
Cite this article
Mallamaci, F., Tripepi, G. Fluid overload and post-dialysis hypertension. Nat Rev Nephrol 10, 623–624 (2014). https://doi.org/10.1038/nrneph.2014.175
Published:
Issue Date:
DOI: https://doi.org/10.1038/nrneph.2014.175
