Hypertension in dialysis patients (HTND) has a high prevalence, affecting at least 80% or more of patients, and its management in the nephrology practice is heterogeneous and often empirical. Knowing how to define, understand the pathophysiology, diagnose, monitor and treat with lifestyle changes, and adjust antihypertensive drugs to achieve the recommended blood pressure (BP) target - to reduce morbidity and mortality - requires specific knowl-edge and approaches within the contexts of hemodialysis (HD) and peritoneal dialysis (PD). This document is the first guideline of the Brazilian Society of Nephrology, developed by the departments of Hypertension and Dialysis. It aims to guide physicians who provide care in dialysis centers on how to manage patients with HTND, in a comprehensive and individualized manner, based on the critical appraisal of the best available scientific evidence. When such evidence is scarce or unavailable, the opinion of specialists should be recommended. The different topics covered include HTND definition (pre-HD BP ≥ 140/90 mmHg and post-HD BP ≥ 130/80 mmHg), epidemiology, and pathophysiology; diagnosis of HTND preferably with BP measurements outside the dialysis setting (BP ≥ 130/80 mmHg); complementary assessment; blood pressure targets; non-pharmacological treatment; use of the most appropriate antihypertensive medications; special situations; and complications of HTND, predominantly cardiovascular ones.
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http://dx.doi.org/10.1590/2175-8239-JBN-2024-0033en | DOI Listing |
Hemodial Int
March 2025
Division of Nephrology, University Health Network, Toronto, Ontario, Canada.
Introduction: Despite being a rare cause of end-stage kidney disease (ESKD), sickle cell disease has broad kidney implications. Patients with both sickle cell disease and ESKD are at a greater risk of adverse events including mortality; while these patients can be managed with hemodialysis (HD), the use of nocturnal HD in sickle cell disease has not been previously described.
Methods: Here, we report a patient with sickle cell disease and ESKD who transitioned from conventional HD to nocturnal home HD.
J Bras Nefrol
March 2025
University of California Los Angeles, Davd Geffen School of Medicine, Department of Medicine, Los Angeles, EUA.
The vast majority of patients with advanced chronic kidney disease (CKD) who transition to end-stage kidney disease (ESKD) are treated with dialysis. Given that dialysis does not always have the intended effects of increasing longevity and/or improving health, particularly in those with high comorbidity burden and/or older age groups, there has been increasing emphasis on interventions that delay or avert the need for renal replacement therapy. Among the multi-disciplinary approaches used to reduce CKD progression, dietary interventions are a major cornerstone.
View Article and Find Full Text PDFAnn Vasc Surg
March 2025
Division of Vascular Surgery and Endovascular Therapy, Loyola University Health System, Loyola University Chicago Stritch School of Medicine. Electronic address:
Objective: The purpose of this study was to conduct a real-world comparison of visceral stent branch related outcomes and patient survival in physician modified endografts (PMEG) versus factory made fenestrated endografts (FMFE).
Methods: After exclusions, 544 PMEG and 1638 FMFE were identified in the Vascular Quality Initiative between 2014 and 2022. The four primary outcomes analyzed with Kaplan Meier (KM) were freedom from mortality, new onset dialysis, visceral ischemia, and visceral stent graft reintervention in follow up.
Am J Hypertens
March 2025
Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Background: We investigated the effects of sacubitril/valsartan, a first-in-class angiotensin receptor neprilysin inhibitor (ARNI), on 24-hour blood pressure (BP) and safety for 12 weeks in Japanese patients with non-dialysis advanced chronic kidney disease (CKD).
Methods: We conducted a prospective, single-arm exploratory study. Patients with non-dialysis CKD stage G4-5 (estimated glomerular filtration (eGFR) <30 mL/min/1.
Clin J Am Soc Nephrol
March 2025
Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Background: Low bone mass and fractures are common among kidney stone formers, yet it remains unclear whether thiazides can help preserve bone mass. We aimed to evaluate the effectiveness of a range of hydrochlorothiazide (HCTZ) doses compared to a placebo on bone mineral density (BMD) over a three-year period.
Methods: This post-hoc analysis was conducted on data from the NOSTONE trial, a multicenter, randomized, controlled study.
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