TY - JOUR
T1 - The lingering dilemma of arterial pressure in CKD: what do we know, where do we go?
AU - Agarwal, Rajiv
AU - Martinez-Castelao, Alberto
AU - Wiecek, Andrzej
AU - Massy, Ziad
AU - Suleymanlar, Gultekin
AU - Ortiz, Alberto
AU - Blankestijn, Peter J.
AU - Covic, Adrian
AU - Dekker, Friedo W.
AU - Jager, Kitty J.
AU - Lindholm, Bengt
AU - Goldsmith, David
AU - Fliser, Danilo
AU - London, Gerard
AU - Zoccali, Carmine
PY - 2011
Y1 - 2011
N2 - Despite many advances in the management of hypertensive chronic kidney disease (CKD) patients, both on and off dialysis, there exist several gaps in our knowledge. Although the modern techniques to measure blood pressure (BP) indirectly have been available for a long time, among those with CKD, how to best assess hypertension and the level to which it should be lowered are mired in controversy. Other controversial areas relate to a lack of a consensus definition of hypertension among hemodialysis patients, uncertainty in the definition and assessment of volume excess, and the lack of adequately powered randomized trials to evaluate the level to which BP can be lowered in those on dialysis. This review discusses the limitations of the available evidence base and suggests areas for future research. Suggestions include evaluation of techniques to assess volume, randomized trials to target different levels of BP among hypertensive hemodialysis patients, evaluation of ambulatory BP monitoring, and non-pharmacological means to lower BP in CKD. It is hoped that among patients with CKD these data will improve the dismal cardiovascular outcomes
AB - Despite many advances in the management of hypertensive chronic kidney disease (CKD) patients, both on and off dialysis, there exist several gaps in our knowledge. Although the modern techniques to measure blood pressure (BP) indirectly have been available for a long time, among those with CKD, how to best assess hypertension and the level to which it should be lowered are mired in controversy. Other controversial areas relate to a lack of a consensus definition of hypertension among hemodialysis patients, uncertainty in the definition and assessment of volume excess, and the lack of adequately powered randomized trials to evaluate the level to which BP can be lowered in those on dialysis. This review discusses the limitations of the available evidence base and suggests areas for future research. Suggestions include evaluation of techniques to assess volume, randomized trials to target different levels of BP among hypertensive hemodialysis patients, evaluation of ambulatory BP monitoring, and non-pharmacological means to lower BP in CKD. It is hoped that among patients with CKD these data will improve the dismal cardiovascular outcomes
U2 - https://doi.org/10.1038/kisup.2011.1
DO - https://doi.org/10.1038/kisup.2011.1
M3 - Review article
C2 - 25018898
SN - 0098-6577
VL - 1
SP - 17
EP - 20
JO - Kidney international. Supplement
JF - Kidney international. Supplement
IS - 1
ER -