Patient-Centered Approach for Hypertension Management in End-Stage Kidney Disease

Art or Science?

Elvira O. Gosmanova, Csaba Kovesdy

Research output: Contribution to journalReview article

Abstract

Summary: Hypertension is present in most patients with end-stage kidney disease initiating dialysis and management of hypertension is a routine but challenging task in everyday dialysis care. End-stage kidney disease patients are uniquely heterogeneous individuals with significant variations in demographic characteristics, functional capacity, and presence of concomitant comorbid conditions and their severity. Therefore, these patients require personalized approaches in addressing not only hypertension but related illnesses, while also accounting for overall prognosis and projected longevity. There are only limited clinical trial data to guide individualized blood pressure management and current guidelines are based predominantly on observational evidence and expert opinions. Inthis review, we reflect on the shortcomings of peridialytic blood pressure recordings and discuss an important paradigm shift toward using out-of-dialysis blood pressure for evaluating hypertension control and for making treatment decisions. In addition, we provide our personal view on blood pressure goals and summarize nonpharmacologic and pharmacologic treatment options for individualized management of hypertension in end-stage kidney disease.

Original languageEnglish (US)
Pages (from-to)355-368
Number of pages14
JournalSeminars in Nephrology
Volume38
Issue number4
DOIs
StatePublished - Jul 1 2018

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Art
Chronic Kidney Failure
Hypertension
Blood Pressure
Dialysis
Expert Testimony
Decision Making
Demography
Clinical Trials
Guidelines
Therapeutics

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Patient-Centered Approach for Hypertension Management in End-Stage Kidney Disease : Art or Science? / Gosmanova, Elvira O.; Kovesdy, Csaba.

In: Seminars in Nephrology, Vol. 38, No. 4, 01.07.2018, p. 355-368.

Research output: Contribution to journalReview article

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