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Titolo Achieving blood pressure targets during dialysis improves control but increases intradialytic hypotension
Autore A. Davenport, C. Cox and R. Thuraisingham, on behalf of the Pan Thames Renal Audit Group
Referenza Kidney International 2007; doi:10.1038/sj.ki.5002745
Contenuto Cardiovascular disease remains the most common cause of mortality in patients with end-stage kidney disease treated by regular hemodialysis. To improve blood pressure control and reduce cardiovascular risk, the United Kingdom Renal Association standards committee introduced pre- and postdialysis target blood pressures of less than 140/90 and 130/80mmHg, respectively. We audited blood pressure control and symptomatic intradialytic hypotension requiring fluid resuscitation in the Greater London area renal centers that serve 2630 patients. The study captured 7890 hemodialysis sessions during a 1-week period where only 36% of the patients achieved the pre-dialysis target and 42% the postdialysis target, with a wide variation between centers. Different antihypertensive medication prescriptions did not affect achievement of these targets. Fifteen percent of the patients suffered symptomatic hypotension requiring fluid resuscitation associated with significantly greater interdialytic weight gains. Our study found that intradialytic hypotension was significantly greater in centers that achieved better post-dialysis blood pressure targeting.
Data 12.02.2008
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