Hypertension in Hemodialysis Patients
By:
Blaise Abramovitz Renal-Electrolyte Division, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania

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and
Branden D. Nemecek Duquesne University School of Pharmacy, Pittsburgh, Pennsylvania and Mercy Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania

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Volume/Issue:
Volume 24: Issue 2
Published Online:
May 2025
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Copyright:
Copyright © 2025 by the American Society of Nephrology 2025
Page Count:
7
Article Category:
Research Article
Print Publication Date:
01 May 2025
Published Online:
May 2025
  • 1.

    Rowan C, Mahoney S, Redahan L: Editor’s Pick: Hypertension in patients receiving dialysis: A review of the current clinical approach. EMJ Nephrol. 2023 doi:10.33590/emjnephrol/10105805

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Bansal N, Artinian NT, Bakris G, Chang T, Cohen J, Flythe J, et al.; American Heart Association Council on the Kidney in Cardiovascular Disease; Council on Cardiovascular and Stroke Nursing; and Council on Epidemiology and Prevention: Hypertension in patients treated with in-center maintenance hemodialysis: Current evidence and future opportunities: A scientific statement from the American Heart Association. Hypertension 80: e112–e122, 2023 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Flythe JE, Bansal N: The relationship of volume overload and its control to hypertension in hemodialysis patients. Semin Dial 32: 500–506, 2019 PubMed

  • 4.

    National Kidney Foundation: KDOQI clinical practice guidelines for cardiovascular disease in dialysis patients. Am J Kidney Dis 45: S16–S153, 2005 PubMed

  • 5.

    Miskulin DC, Gassman J, Schrader R, Gul A, Jhamb M, Ploth DW, et al.: BP in dialysis: Results of a pilot study. J Am Soc Nephrol 29: 307–316, 2018 PubMed

  • 6.

    Kanbay M, Ertuglu LA, Afsar B, Ozdogan E, Siriopol D, Covic A, et al.: An update review of intradialytic hypotension: Concept, risk factors, clinical implications and management. Clin Kidney J 13: 981–993, 2020 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Sarafidis PA, Persu A, Agarwal R, Burnier M, de Leeuw P, Ferro CJ, et al.: Hypertension in dialysis patients: A consensus document by the European Renal and Cardiovascular Medicine working group of the European Renal Association-European Dialysis and Transplant Association and the Hypertension and the Kidney working group of the European Society of Hypertension. Nephrol Dial Transplant 32: 620–640, 2017 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    National Kidney Foundation: KDOQI clinical practice guideline for hemodialysis adequacy: 2015 update. Am J Kidney Dis 66: 884–930, 2015 PubMed

  • 9.

    Peixoto AJ, Santos SF, Mendes RB, Crowley ST, Maldonado R, Orias M, et al.: Reproducibility of ambulatory blood pressure monitoring in hemodialysis patients. Am J Kidney Dis 36: 983–990, 2000 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Theodorakopoulou M, Georgiou A, Iatridi F, Karkamani E, Stamatiou A, Devrikis N, et al.: Accuracy of 24 h ambulatory blood pressure recordings for diagnosing high 44 h blood pressure in hemodialysis: A diagnostic test study. Hypertens Res 47: 1042–1050, 2024 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Agarwal R, Andersen MJ, Bishu K, Saha C: Home blood pressure monitoring improves the diagnosis of hypertension in hemodialysis patients. Kidney Int 69: 900–906, 2006 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Bansal N, Glidden DV, Mehrotra R, Townsend RR, Cohen J, Linke L, et al.: Treating home versus predialysis blood pressure among in-center hemodialysis patients: A pilot randomized trial. Am J Kidney Dis 77: 12–22, 2021 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Agarwal R: Blood pressure and mortality among hemodialysis patients. Hypertension 55: 762–768, 2010 PubMed

  • 14.

    Cohen JB, Hsu CY, Glidden D, Linke L, Palad F, Larson HL, et al.: Ambulatory and home blood pressure monitoring in hemodialysis patients: A mixed-methods study evaluating comparability and tolerability of blood pressure monitoring. Kidney Med 3: 457–460, 2021 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Alborzi P, Patel N, Agarwal R: Home blood pressures are of greater prognostic value than hemodialysis unit recordings. Clin J Am Soc Nephrol 2: 1228–1234, 2007 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Bansal N, McCulloch CE, Rahman M, Kusek JW, Anderson AH, Xie D, et al.; CRIC Study Investigators: Blood pressure and risk of all-cause mortality in advanced chronic kidney disease and hemodialysis: The chronic renal insufficiency cohort study. Hypertension 65: 93–100, 2015 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Agarwal R, Peixoto AJ, Santos SF, Zoccali C: Pre- and postdialysis blood pressures are imprecise estimates of interdialytic ambulatory blood pressure. Clin J Am Soc Nephrol 1: 389–398, 2006 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Agarwal R, Andersen MJ, Pratt HJ: On the importance of pedal edema in hemodialysis patients. Clin J Am Soc Nephrol 3: 153–158, 2008 PubMed

  • 19.

    Nekooeian M, Roozbeh J, Jahromi SE, Moaref A, Masjedi F: The superiority of bioimpedance vs. echocardiography and pitting edema in predicting automated office blood pressure in continuous ambulatory peritoneal dialysis patients. Ther Apher Dial 28: 272–283, 2024 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Covic A, Ciumanghel AI, Siriopol D, Kanbay M, Dumea R, Gavrilovici C, et al.: Value of bioimpedance analysis estimated “dry weight” in maintenance dialysis patients: A systematic review and meta-analysis. Int Urol Nephrol 49: 2231–2245, 2017 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Rodriguez HJ, Domenici R, Diroll A, Goykhman I: Assessment of dry weight by monitoring changes in blood volume during hemodialysis using Crit-Line. Kidney Int 68: 854–861, 2005 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Raz MA, Grupper A, Soetendorp H, Feder O, Amsterdam D, Schwartz D, et al.: Use of lung ultrasound to assess volume status and its association with physical examination in patients with chronic kidney disease. Clin Kidney J 17: sfae167–9, 2024 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Elgenidy A, Amin MA, Awad AK, Emad A, Nassar A, Alomari O, et al.: The use of lung ultrasound in evaluation of extravascular lung water in hemodialysis patients: Systematic review and meta-analysis. Hemodial Int 28: 148–161, 2024 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Ahmad S: Dietary sodium restriction for hypertension in dialysis patients. Semin Dial 17: 284–287, 2004 PubMed

  • 25.

    Agarwal R, Alborzi P, Satyan S, Light RP: Dry-weight reduction in hypertensive hemodialysis patients (DRIP): A randomized, controlled trial. Hypertension 53: 500–507, 2009 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Loutradis C, Sarafidis PA, Ekart R, Tsouchnikas I, Papadopoulos C, Kamperidis V, et al.: Ambulatory blood pressure changes with lung ultrasound-guided dry-weight reduction in hypertensive hemodialysis patients: 12-month results of a randomized controlled trial. J Hypertens 39: 1444–1452, 2021 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    McGregor DO, Buttimore AL, Nicholls MG, Lynn KL: Ambulatory blood pressure monitoring in patients receiving long, slow haemodialysis. Nephrol Dial Transplant 14: 2676–2679, 1999 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Culleton BF, Walsh M, Klarenbach SW, Mortis G, Scott-Douglas N, Quinn RR, et al.: Effect of frequent nocturnal hemodialysis vs conventional hemodialysis on left ventricular mass and quality of life: A randomized controlled trial. JAMA 298: 1291–1299, 2007 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Chertow GM, Levin NW, Beck GJ, Depner TA, Eggers PW, Gassman JJ, et al.; FHN Trail Group: In-center hemodialysis six times per week versus three times per week. N Engl J Med 363: 2287–2300, 2010 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Kotanko P, Garg AX, Depner T, Pierratos A, Chan CT, Levin NW, et al.; FHN Trial Group: Effects of frequent hemodialysis on blood pressure: Results from the randomized frequent hemodialysis network trials. Hemodial Int 19: 386–401, 2015 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Bratsiakou A, Iatridi F, Theodorakopoulou M, Sarafidis P, Goumenos DS, Papachristou E, et al.: The effect of different dialysate sodium concentrations on ambulatory blood pressure in hemodialysis patients: A prospective interventional study. Clin Kidney J 17: sfae041–9, 2024 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Kim IS, Kim S, Yoo T-H, Kim J-K: Diagnosis and treatment of hypertension in dialysis patients: A systematic review. Clin Hypertens 29: 24, 2023 PubMed

  • 33.

    Bazzato G, et al.: Prevention of intra- and post dialytic hypertensive crises by captopril. Contrib Nephrol 41: 292–298, 2009 PubMed

  • 34.

    Zannad F, Kessler M, Lehert P, Grünfeld JP, Thuilliez C, Leizorovicz A, et al.: Prevention of cardiovascular events in end-stage renal disease: Results of a randomized trial of fosinopril and implications for future studies. Kidney Int 70: 1318–1324, 2006 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Ruggenenti P, Podestà MA, Trillini M, Perna A, Peracchi T, Rubis N, et al.; ARCADIA Study Organization: Ramipril and cardiovascular outcomes in patients on maintenance hemodialysis. The ARCADIA multicenter randomized controlled trial. Clin J Am Soc Nephrol 16: 575–587, 2021 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36.

    Agarwal R, Sinha AD, Pappas MK, Abraham TN, Tegegne GG: Hypertension in hemodialysis patients treated with atenolol or lisinopril; a randomized controlled trial. Nephrol Dial Transplant 29: 672–681, 2014 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    Iseki K, Arima H, Kohagura K, Komiya I, Ueda S, Tokuyama K, et al.; Olmesartan Clinical Trial in Okinawan Patients Under OKIDS (OCTOPUS) Group: Effects of angiotensin receptor blockage (ARB) on mortality and cardiovascular outcomes in patients with long-term haemodialysis: A randomized controlled trail. Nephrol Dial Transplant 28: 1579–1589, 2013 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    Peters CD, Kjaergaard KD, Jensen JD, Christensen KL, Strandhave C, Tietze IN, et al.: No significant effect of angiotensin II receptor blockage on intermediate cardiovascular end points in hemodialysis patients. Kidney Int 86: 625–637, 2014 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39.

    Tai DJ, Lim TW, James MT, Manns BJ, Tonelli M, Hemmelgarn BR, et al.; Alberta Kidney Disease Network: Cardiovascular effects of angiotensin converting enzyme inhibition of angiotensin receptor blockage in hemodialysis: A meta-analysis. Clin J Am Soc Nephrol 5: 623–630, 2010 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 40.

    Weir MA, Dixon SN, Fleet JL, Roberts MA, Hackam DG, Oliver MJ, et al.: B-blocker dialyzability and mortality in older patients receiving hemodialysis. J Am Soc Nephrol 26: 987–996, 2015 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 41.

    Wu P-H, Lin Y-T, Kuo M-C, Liu J-S, Tsai Y-C, Chiu Y-W, et al.: β-blocker dialyzability and the risk of mortality and cardiovascular events in patients undergoing hemodialysis. Nephrol Dial Transplant 35: 1959–1965, 2020 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 42.

    Wetmore JB, Mahnken JD, Phadnis MA, Ellerbeck EF, Shireman TI: Relationship between calcium channel blocker class and mortality in dialysis. Pharmacoepidemiol Drug Saf 24: 1249–1258, 2015 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 43.

    Tepel M, Hopfenmueller W, Scholze A, Maier A, Zidek W: Effect of amlodipine on cardiovascular events in hypertensive haemodialysis patients. Nephrol Dial Transplant 23: 3605–3612, 2008 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 44.

    Youssef AM, Elghoneimy HA, Helmy MW, Abdelazeem AM, El-Khodary NM: Effect of amlodipine versus bisoprolol in hypertensive patients on maintenance hemodialysis. Medicine (Baltimore) 100: e28322, 2021 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 45.

    Matsumoto Y, Mori Y, Kageyama S, Arihara K, Sugiyama T, Ohmura H, et al.: Spironolactone reduces cardiovascular and cerebrovascular morbidity and mortality in hemodialysis patients. J Am Coll Cardiol 63: 528–536, 2014 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 46.

    Lin C, Zhang Q, Zhang H, et al.: Long-term effects of low-dose spironolactone on chronic dialysis patients: A randomized placebo-controlled study. J Clin Hypertens 18: 121–128, 2016 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 47.

    Charytan DM, Himmelbarb J, Ikizler TA, et al.; Hemodialysis Novel Therapies Consortium: Safety and cardiovascular efficacy of spironolactone in dialysis-dependent ESRD (Spin-D) a randomized, placebo-controlled, multiple dose trail. Kidney Int 95: 973–982, 2019 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 48.

    Walsh M, Manns B, Garg AX, Bueti J, Rabbat C, Smyth A, et al.: The safety of eplerenone in hemodialysis patients: A noninferiority randomized controlled trail. Clin J Am Soc Nephrol 10: 1602–1608, 2015 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 49.

    Derk G, Barton A, An R, Fang H-Y, Ashrafi SA, Wilund K, et al.: The safety and efficacy of clonidine in hemodialysis patients: a systematic review and meta-analysis. Pharmacology 107: 545–555, 2022 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 50.

    Charytan DM, Hsu JY, Mc Causland FR, Waikar SS, Ikizler TA, Raj DS, et al.; Hemodialysis Novel Therapies Consortium: Combination hydralazine and isosorbide dinitrate in dialysis-dependent ESRD (HIDE): A randomized placebo-controlled. Pilot Trial. Kidney360 1 1: 1380–1389, 2020 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 51.

    Mavrakanas TA, Soomro QH, Charytan DM: Hydralazine-isosorbide dintirate use in patients with end-stage kidney disease on dialysis. Kidney Int Rep 7: 1332–1340, 2022 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 52.

    Lemes HP, Araujo S, Nascimento D, Cunha D, Garcia C, Queiroz V, et al.: Use of small doses of furosemide in chronic kidney disease patients with residual renal function undergoing hemodialysis. Clin Exp Nephrol 15: 554–559, 2011 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation

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