Dialysis is a life-saving treatment for patients who have reached end-stage disease and can no longer survive without some kind of renal replacement therapy. This treatment is imperfect, as it has a 33.6 percent survival rate after five years of treatment. Vigilant blood pressure control improves survival and reduces the risk of cardiovascular disease.
Hemodialysis Function
Hemodialysis is one technique for cleaning the blood of patients who have end-stage disease. Blood is continuously removed from the patient via a catheter, run through a dialyzer filter and returned back to the patient's body. If hemodialysis is performed in a dialysis center, individual sessions take three to four hours. Most patients need to be dialyzed at least three to four times per week.
Hypertension and the Kidneys
Hypertension affects most kidney patients because the kidneys help regulate blood pressure. The high incidence of hypertension explains, in part, why heart disease is the leading cause of death among kidney patients. Since treating this reduces mortality, P.N. van Buren states that "hypertension in adult and pediatric hemodialysis patients warrants aggressive management," in his February 2011 article in "Pediatric Nephrology."
Liquid Removal
While a low-sodium diet and blood pressure medications continue to play an important role for hemodialysis patients, nephrologists also consider the amount of liquids that are removed from patients during dialysis. Since dialysis patients are usually unable to produce urine, liquids are removed from their bodies during dialysis. If too much liquid is removed, the patient feels washed out. If not enough liquid is removed, hypertension is a problem.
Tips
Several practices help hemodialysis patients control their blood pressure. Compliance with taking medication is a first step. Following the nephrologist's guidelines for limiting dietary sodium and intake of liquids is also very important. Keeping your dialysis provider aware of dietary changes that have taken place and whether you have exceeded the recommended intake of sodium and liquids helps her optimize the treatment for your particular needs.
References
- "Pediatric Nephrology"; Hypertension and Hemodialysis: Pathophysiology and Outcomes in Adult and Pediatric Populations; P.N. van Buren; Feb. 2011
- DaVita: How Dry Weight and Fluid Gain Affect Dialysis Patients
- National Institute of Diabetes and Digestive and Kidney Disease: Hemodialysis
- National Institute for Diabetes and Digestive and Kidney Diseases: Kidney and Urologic Diseases Statistics for the United States
