Anti-Hypertensive Drug Requirements in Continuous Ambulatory Peritoneal Dialysis

1984 ◽  
Vol 4 (2) ◽  
pp. 85-88 ◽  
Author(s):  
Michael A. Young ◽  
Karl D. Nolph ◽  
Sue Dutton ◽  
Barbara Prowant
Keyword(s):  
Blood Pressure ◽  
Peritoneal Dialysis ◽  
Retrospective Analysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Antihypertensive Drug ◽  
Body Fluid ◽  
Sodium Balance ◽  
Control Blood Pressure ◽  
Antihypertensive Medications ◽  
Hypertensive Drug

This retrospective analysis documents changes in antihypertensive drug requirements with time on CAPD. In 59 patients who were hypertensive at initiation of CAPD, antihypertensive drug use decreased from almost 1.2 to less than 0.3 drugs per patient during the first month. In this group, the proportion in whom blood pressure was controlled without drugs went from 0% to nearly 60% after 12 months. These results, which most likely reflect control of body -fluid volumes and sodium balance, are similar to those reported with hemodialysis. It has been noted that patients receiving antihypertensive medications to control blood pressure at the initiation of continuous ambulatory peritoneal dialysis (CAPD) frequently require fewer or no anti-hypertensive medications with time on CAPD (1–2). The purpose of this retrospective analysis was to quantitate the extent and the timing of this trend in a CAPD population at a single center.

Loss of Ultrafil Tration in Continuous Ambulatory Peritoneal Dialysis: A Role for Acetate

1989 ◽  
Vol 9 (2) ◽  
pp. 107-111 ◽  
Author(s):  
Bernadette Faller ◽  
Jean-Francois Marichal
Keyword(s):  
Peritoneal Dialysis ◽  
Retrospective Analysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Prolonged Exposure ◽  
Ultra Filtration

A retrospective analysis of the ultra-filtration (UF) capacity of patients treated by continuous ambulatory peritoneal dialysis since 1978 showed that in all 31 patients using acetatebuttered dialysate the UF decreased whereas it decreased in only two (14%) of 14 patients using lactate dialysate. Prolonged exposure of the peritoneum to acetate dialysate seems to be responsible for this loss of UF.

Volume Status and Blood Pressure in Continuous Ambulatory Peritoneal Dialysis Patients

2005 ◽  
Vol 23 (5) ◽  
pp. 373-378 ◽  
Author(s):  
Xin Wang ◽  
Jonas Axelsson ◽  
Bengt Lindholm ◽  
Tao Wang
Keyword(s):  
Blood Pressure ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Volume Status ◽  
Dialysis Patients

scholarly journals Clinical relevance of central blood pressure - a critical review

VASA ◽  
2016 ◽  
Vol 45 (6) ◽  
pp. 451-460 ◽  
Author(s):  
Michael Kostapanos ◽  
Carmel M. McEniery ◽  
Ian B. Wilkinson
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Drug ◽  
Clinical Relevance ◽  
Beta Blockers ◽  
Organ Damage ◽  
Cardiovascular Outcomes ◽  
Central Blood Pressure ◽  
Antihypertensive Medications ◽  
Brachial Blood Pressure ◽  
Drug Classes

Abstract. Vital organs are exposed to the central rather than the brachial blood pressure. To date, central blood pressure can be assessed noninvasively through the use of several devices. In this review, we critically discuss the clinical relevance of central blood pressure assessment. Considerable evidence suggests that central blood pressure is a better predictor of end-organ damage than brachial blood pressure. However, there is still uncertainty concerning the value of central pressure for predicting cardiovascular outcomes, as the existing studies are underpowered to address this issue. A full synthesis of the available data is needed in this regard. Among the different antihypertensive drug classes, beta-blockers appear to lower central blood pressure less than brachial blood pressure. This difference may, at least in part, explain the reduced efficacy of beta-blockers in the prevention of cardiovascular outcomes compared with the other antihypertensive drug classes, which may lower central and brachial blood pressure to a similar extent. Nevertheless, this differential effect might not be relevant to the newer beta-blockers with vasodilating properties, including nebivolol, celliprolol and carvedilol. However, whether a preferential reduction of central blood pressure results in better outcomes should be further assessed by appropriately powered clinical trials. Other emerging challenges include the assessment of the potential predictive value of central blood pressure variability and the development of new antihypertensive medications based on central blood pressure rather than brachial blood pressure.

scholarly journals The Effect of Antihypertensive Medications on Testing for Primary Aldosteronism

2021 ◽  
Vol 12 ◽  
Author(s):  
Piotr Jędrusik ◽  
Bartosz Symonides ◽  
Jacek Lewandowski ◽  
Zbigniew Gaciong
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Drug ◽  
Primary Aldosteronism ◽  
Angiotensin Receptor Blockers ◽  
Suboptimal Control ◽  
Aldosterone Secretion ◽  
Antihypertensive Medications ◽  
Specific Patient ◽  
Drug Classes ◽  
Cardiovascular Morbidity And Mortality

Primary aldosteronism (PA) is a potentially curable form of secondary hypertension caused by excessive renin-independent aldosterone secretion, leading to increased target organ damage and cardiovascular morbidity and mortality. The diagnosis of PA requires measuring renin and aldosterone to calculate the aldosterone-to-renin ratio, followed by confirmatory tests to demonstrate renin-independent aldosterone secretion and/or PA subtype differentiation. Various antihypertensive drug classes interfere with the renin-angiotensin-aldosterone axis and hence evaluation for PA should ideally be performed off-drugs. This is, however, often precluded by the risks related to suboptimal control of blood pressure and serum potassium level in the evaluation period. In the present review, we summarized the evidence regarding the effect of various antihypertensive drug classes on biochemical testing for PA, and critically appraised the issue whether and which antihypertensive medications should be withdrawn or, conversely, might be continued in patients evaluated for PA. The least interfering drugs are calcium antagonists, alpha-blockers, hydralazine, and possibly moxonidine. If necessary, the testing may also be attempted during treatment with beta-blockers, angiotensin-converting enzyme inhibitors, and angiotensin receptor blockers but renin and aldosterone measurements must be interpreted in the context of known effects of these drugs on these parameters. Views are evolving on the feasibility of testing during treatment with mineralocorticoid receptor antagonists, as these drugs are now increasingly considered acceptable in specific patient subsets, particularly in those with severe hypokalemia and/or poor blood pressure control on alternative treatment.

scholarly journals The chaos of hypertension guidelines for chronic kidney disease patients

2019 ◽  
Vol 12 (6) ◽  
pp. 771-777 ◽  
Author(s):  
Esmeralda Castillo-Rodriguez ◽  
Beatriz Fernandez-Fernandez ◽  
Raquel Alegre-Bellassai ◽  
Mehmet Kanbay ◽  
Alberto Ortiz
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Drug Therapy ◽  
Kidney Disease ◽  
Antihypertensive Drug ◽  
Secondary Hypertension ◽  
Antihypertensive Drug Therapy ◽  
Hypertensive Drug ◽  
Definition Of ◽  
Current Guidelines

Abstract Three major guidelines deal with blood pressure thresholds and targets for antihypertensive drug therapy in chronic kidney disease (CKD) patients: the 2012 Kidney Disease: Improving Global Outcomes Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease; the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults; and the 2018 ESC/ESH Guidelines for the Management of Arterial Hypertension. However, a careful reading of the three guidelines leaves the practicing physician confused about the definition of CKD, how hypertension and secondary hypertension should be diagnosed in CKD patients and what the blood pressure thresholds, targets and compelling indications of antihypertensive drug therapy should be for this population. Current guidelines refer to different CKD populations and propose different definitions of hypertension, different thresholds to initiate antihypertensive therapy in CKD patients and different BP targets compelling antihypertensive drug use. The different bodies producing guidelines should work together towards a unified definition of CKD, a unified concept of hypertension and unified BP thresholds and targets for hypertensive drug therapy for CKD patients. Otherwise they risk promoting confusion and therapeutic nihilism among physicians and patients.

Prevalence of Symptomatic Arterial Disease and Risk Factors for its Development in Patients on Continuous Ambulatory Peritoneal Dialysis

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 406-408 ◽  
Author(s):  
Alan T. Webb ◽  
Edwina A. Brown
Keyword(s):  
Blood Pressure ◽  
Peritoneal Dialysis ◽  
Systolic Blood Pressure ◽  
Vascular Disease ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Arterial Disease ◽  
Considerable Proportion ◽  
Elevated Systolic Blood Pressure ◽  
Peripheral Arterial ◽  
Control Study

The prevalence of coronary, cerebral, and peripheral arterial disease was assessed using a standard cardiovascular questionnaire in a cohort of 70 patients on continuous ambulatory peritoneal dialysis (CAPD). Symptomatic vascular disease was found in 47% of patients, 72% of whom were smokers and 30% diabetic. In 39% of these patients vascular disease was evident prior to the commencement of peritoneal dialysis. A case control study matching for age and sex revealed patients with vascular disease to have higher median systolic blood pressure (162 mmHg vs 150 mmHg, p=0.026), cholesterol (6.60 mmol/L vs 6.00 mmol/L, p=0.014), and LDL cholesterol (4.80 mmol/L vs 3.80 mmol/L, p=0.009). Vascular disease is common in patients on peritoneal dialysis, a considerable proportion of whom have the disease prior to the commencement of dialysis. Elevated systolic blood pressure and hypercholesterolemia, but not smoking, are most closely associated with vascular disease in these patients.

Seasonal Variation in Blood Pressure of Patients on Continuous Ambulatory Peritoneal Dialysis

2006 ◽  
Vol 24 (5-6) ◽  
pp. 499-507 ◽  
Author(s):  
Li-Tao Cheng ◽  
Hong-Ying Jiang ◽  
Li-Jun Tang ◽  
Tao Wang
Keyword(s):  
Blood Pressure ◽  
Peritoneal Dialysis ◽  
Seasonal Variation ◽  
Continuous Ambulatory Peritoneal Dialysis
Sign in / Sign up

Export Citation Format

Share Document