Why the study?
Does starting dialysis improve blood pressure control in patients with end-stage renal failure?
Does starting dialysis improve blood pressure control in patients with end-stage renal failure?
Starting dialysis significantly improves blood pressure control and reduces the need for antihypertensive medications in patients with end-stage renal failure.
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Dialysis initiation was associated with better BP control on fewer agents; observational data leave causality and practice implications open.
BACKGROUND/AIM: We have previously reported a study on the adequacy of management of hypertension in patients developing end-stage renal failure (ESRF) over a period of 3 years from a single health district in the UK (n = 107). There were significant shortcomings in all aspects of management of hypertension including blood pressure (BP) control. METHODS: In this report, we have compared BP control in the same cohort of patients before and after starting renal replacement therapy (RRT). RESULTS: BP control improved significantly after the patients were established on dialysis (mean 158/ 87 mm Hg pre-RRT vs. 152/82 mm Hg post-RRT; p < 0.0001), and fewer antihypertensive agents were prescribed to control BP (mean 2.45 vs. 1.74) in this period (p < 0.0001). Moreover, patients on continuous ambulatory peritoneal dialysis (n = 50) had a better systolic BP control compared with the haemodialysis patients (n = 57; p = 0.03). CONCLUSIONS: This study shows significant improvement in BP control in a cohort of patients with ESRF following the start of dialysis.
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Dasgupta et al. (2005) studied this question.
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