15 BPU441313.indd
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Background: Intradialytic hypertension is a condition where there is an increase in blood pressure (BP) from preto posthemodialysis; this condition has been recently identified as an independent mortality risk factor in hypertensive hemodialysis patients. The mechanisms and management of intradialytic hypertension have been explored in numerous research studies over the past few years. Summary: Patients with intradialytic hypertension have been found to be more chronically volume overloaded compared to other hemodialysis patients, although no causal role has been established. Patients with intradialytic hypertension have intradialytic vascular resistance surges that likely explain the BP increase during dialysis. Acute intradialytic changes in endothelial cell function have been proposed as etiologies for the increase in vascular resistance, although it is unclear if endothelin-1 or some other vasoconstrictive peptide is responsible. There is an association between dialysate to serum sodium gradients and BP increase during dialysis in patients with intradialytic hypertension, although it is unclear if this Published online: January 15, 2016 Jula K. Inrig, MD, MHS Duke University Medical Center 20205 Chandler Drive Yorba Linda, CA 92887 (USA) E-Mail Jula.Inrig @ duke.edu © 2016 S. Karger AG, Basel 0253–5068/16/0413–0188$39.50/0
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تاریخ انتشار 2015