Management of arterial hypertension in patients with chronic kidney disease on hemodialysis

Abstract

The article is a review of information about the management of arterial hypertension (AH) on hemodialysis. This problem is relevant due to poor elaboration. At the same time, the prevalence of AH on hemodialysis is 91,4 %. The article discusses surveys concerning criteria for determining AH on hemodialysis and methodological approaches to its registration, target values of blood pressure during therapy. The concept of intradialysis hypertension, issues of the pathogenesis of AH on hemodialysis are also considered. The author presents approaches to nondrug therapy and drug treatment of patients with AH on hemodialysis. In particular, approaches to the control of sodium and volemic status within the framework of patient-dependent and apparatus-dependent technologies are considered. Data on the effectiveness of the use of certain classes of antihypertensive drugs are presented, in particular, diuretics, blockers of the renin-angiotensin-aldosterone system, beta-blockers, calcium channel antagonists, mineralocorticoid receptors are considered. The article reflects the needs of modern clinical practice in conducting evidence-based medicine research and identifies the critical points of orientation of such research.