Hypertension in End-Stage Renal Disease

Hypertension is both a leading etiology of end-stage renal disease (ESRD) and a well-recognized cardiovascular risk factor in ESRD patients on dialysis. Despite this, hypertension remains highly prevalent and is often inadequately controlled in this population.[1,2] The prevalence estimates of hypertension in ESRD are quite variable, due to the lack of a standard definition for diagnosis as well as the setting and technique of blood pressure (BP) measurement. Hypertension and chronic kidney disease (CKD) are indeed closely interrelated clinical conditions such that sustained uncontrolled hypertension can cause worsening of renal function and vice versa. Here, we will consider the diagnosis and treatment of hypertension in ESRD patients on renal replacement therapy including both nonpharmacologic and pharmacologic approaches.