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Main > Kidney Disease > Renal Failure > Renal Failure Complications >
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Why It Is Hard to Control High Blood Pressure in Patients with ESRD

2012-10-26 09:12

Lots of patients with ESRD (End-stage Renal Disease) may have high blood pressure which is hard to control even with multiple medications they take. Why would that happen? Why is it hard to control hypertension in patients with ESRD?

There are four major reasons accounting for the uncontrolled elevated blood pressure in Renal Failure patients:

1. 80-90% of patients with Chronic Renal Failure have a high blood pressure due to their declined kidney function. Once the kidney fails, excretion of sodium decreases accordingly. Total exchangeable sodium increases inside the body leading to increased extracellular fluid capacity. Hypertension attacks consequently.

2. RAAS (Renin-angiotensin–aldosterone system) becomes hyperactively which becomes the second big reason resulting in elevated blood pressure in patients with ESRD. Why RAAS is overactive? This is because End-stage Renal Disease patients usually suffer from renal ischemia, blood pressure elevates due to the increased secretion of rennin, angiotensin and aldosterone.

3. secondary hyperparathyroidism

4. Due to the failed kidneys, patients with ESRD have reduced phosphorus excretion. Consequently, hyperphosphatemia attacks. The appearance of hyperphosphatemia is often accompanied with hypocalcemia. Hypocalcemia develops and then hyperparathyroidism develops. How is secondary hyperparathyroidism related with increased blood pressure? PTH (Parathyroid Hormone) could combine with receptor of vascular smooth muscle, calcium influx and contraction of smooth muscle develop as a result. Hypertension develops consequently.

5. Other reasons

EDLS (Endogenous Digitalis like Substance), increased insulin, plasmakinin, ANP and some other factors all take part in the formation of hypertension.

After knowing the causes of high blood pressure in patients with ESRD, how to get it controlled becomes a burning question.

1. Dialysis is an effective approach to lower one’s blood pressure in a short time. Both hemodialysis and peritoneal dialysis will be fine. If you are hooked up on dialysis machine already but still suffer from high blood pressure, then please check if your dialysis is adequate or not since adequate dialysis will just solve this hypertension problem.

2. Correcting complications together with hypertension helps. Common complications like secondary hyperparathyroidism, hyperlipemia, diabetes and hypocalcemia just like I just said before should be corrected because those complications may weaken the effects.

3. Certain drugs may induce your high blood pressure, so eliminate those drugs if so. Talk with your doctor and you can get your answers.

4. Make certain changes not just on diet but lifestyles.

5. The proper hypotensor should be adopted too.

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Tag: Renal Failure Renal Failure Complications

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