Table 2.

Management of hypertension

Summary Statements

1. Volume overload is often an overlooked factor in managing hypertension. Erythropoietin-induced hypertension and untreated sleep apnea are other important causes.

2. Volume overload is associated with increased mortality in HD patients.

3. The iterative trial-and-error method of dry weight assessment remains the current clinical standard in assessing volume status.

4. Dietary salt restriction and individualizing dialysate sodium prescription may improve the feasibility of achieving dry weight.

5. Probing dry weight can improve BP among hypertensive HD patients. The long-term risks and benefits of probing dry weight need to be examined in future trials.

6. Delivery of dialysis of at least 4 hours duration three times a week may facilitate volume and hypertension control.

7. Antihypertensive drugs are frequently needed to control hypertension but are an adjunct to facilitate volume control. Diuretics have little to no role in patients with ESRD. β-blockers may be preferred to other agents.