PREVALANCE OF HYPENTENSION IN HEMODIALYSIS PATIENTS AND THE IMPORTANCE OF VOLUME CONTROL

Hypertension (HT) is very common in hemodialysis (HD) patients, and this is the most important factor that increase cardiovascular morbidity and mortality. In this study, we determimined theprevalance ofHT ( 2140/90 mmHg) and the effect of one year strict volume control on blood pressure levels in 57 patients (28 females, 29 'males) undergoing HD in our HD unit since April 1999. Although almost half of the patients (49.1%) were taking antihypertensive drugs, 33 percent of them were still hypertensive on April 1999. These patients had a greater interdialytic weight gain (4.5%). In addition to strict salt restriction, persistent ultrafiltration was applied until achieving dialysis hypotension. Antihypertensive drugs of the patients whose blood pressure reduced with volume control were discontinued gradually. With this procedure, systolic and diastolic blood pressure levels significantly reduced (from 134.5+24.9 mmHg to 125.8+18.0 mmHg, p=0.005 and form 79.3+15.9 mmHg to 76.1+11.7 mmHg, p=0.067, respectively) and the prevalence of HT was decreased to 5.3% at the end of one year period. We concluded that normal blood pressure levels could be reached in most of the patients with strict volume control by ultrafiltration. Therefore, before starting antihypertensive drug treatment the real dry weight should be achieved by strict volume control in HD patients.