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Intensive Hemodialysis, Blood Pressure
and Antihypertensive Medication Use
Bakris GL, Burkhart JM, Weinhandl ED, McCullough PA, Kraus MA. Intensive
Hemodialysis, Blood Pressure, and Antihypertensive Medication Use. American
Journal of Kidney Diseases, Volume 68, Issue 5, S15 - S23.
AdvancingDialysis.org
1The DOPPS Practice Monitor. http://www.dopps.org/DPM/. Accessed May 20,
2015.
OVER 60%
OF CONVENTIONAL
HEMODIALYSIS
PATIENTS
>140 MMHG SBP
Despite substantial use of multiple
antihypertensive agents, most hemodialysis
patients have elevated pre-dialysis blood
pressure.1
CHAPTER 2, FIGURE 1:
Distribution of pre-dialysis systolic blood pressure in the
Dialysis Outcomes and Practice Patterns Study Practice
Monitor, December 2015.1
AdvancingDialysis.org
1FHN Trial Group, Chertow GM, Levin NW, et al. In-center hemodialysis six times
per week versus three times per week. N Engl J Med. 2010;363(24):2287-2300.
doi:10.1056/NEJMoa1001593. 2Rocco MV, Lockridge RS, Beck GJ, et al. The
effects of frequent nocturnal home hemodialysis: the Frequent Hemodialysis
Network Nocturnal Trial. Kidney Int. 2011;80(10):1080-1091.
doi:10.1038/ki.2011.213. 3Culleton BF, Walsh M, Klarenbach SW, et al. Effect of
frequent nocturnal hemodialysis vs conventional hemodialysis on left ventricular
mass and quality of life: a randomized controlled trial. JAMA. 2007;298(11):1291-
1299. doi:10.1001/jama.298.11.1291.
Multiple randomized clinical trials show
intensive hemodialysis significantly
lowers blood pressure.1,2,3
CHAPTER 2, FIGURE 2:
Effects of intensive versus conventional hemodialysis on
pre-dialysis systolic blood pressure in the FHN Daily Trial,1
the FHN Nocturnal Trial,2 and the Canadian trial of
nocturnal hemodialysis.3
Estimated treatment effects (solid dots) and associated
95% confidence intervals (solid lines) are displayed at the
bottom.
-10 mmHg
-11 mmHg
-8 mmHg
AdvancingDialysis.org
.
1Kotanko P, Garg AX, Depner T, et al. Effects of frequent hemodialysis on blood
pressure: Results from the randomized frequent hemodialysis network trials.
Hemodial Int Int Symp Home Hemodial. 2015;19(3):386-401. doi:10.1111/hdi.12255.
2Culleton BF, Walsh M, Klarenbach SW, et al. Effect of frequent nocturnal
hemodialysis vs. conventional hemodialysis on left ventricular mass and quality of life:
a randomized controlled trial. JAMA. 2007;298(11):1291-1299.
doi:10.1001/jama.298.11.1291.
In the FHN Daily Trial, the number of
antihypertensive medications per patient
declined from 2.2 to 1.4.1
In trials of nocturnal hemodialysis, the
number of antihypertensive
medications per patients decreased
similarly.2
CHAPTER 2, FIGURE 3:
Mean number of prescribed antihypertensive medications
at baseline, at month 4, and at month 12 of the FHN Daily
Trial.1
Dashed bars span one standard deviation above and below
the mean.
36%DECREASE AT
MONTH 12
AdvancingDialysis.org

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Advancing Dialysis - Hypertension

  • 1. Intensive Hemodialysis, Blood Pressure and Antihypertensive Medication Use Bakris GL, Burkhart JM, Weinhandl ED, McCullough PA, Kraus MA. Intensive Hemodialysis, Blood Pressure, and Antihypertensive Medication Use. American Journal of Kidney Diseases, Volume 68, Issue 5, S15 - S23. AdvancingDialysis.org
  • 2. 1The DOPPS Practice Monitor. http://www.dopps.org/DPM/. Accessed May 20, 2015. OVER 60% OF CONVENTIONAL HEMODIALYSIS PATIENTS >140 MMHG SBP Despite substantial use of multiple antihypertensive agents, most hemodialysis patients have elevated pre-dialysis blood pressure.1 CHAPTER 2, FIGURE 1: Distribution of pre-dialysis systolic blood pressure in the Dialysis Outcomes and Practice Patterns Study Practice Monitor, December 2015.1 AdvancingDialysis.org
  • 3. 1FHN Trial Group, Chertow GM, Levin NW, et al. In-center hemodialysis six times per week versus three times per week. N Engl J Med. 2010;363(24):2287-2300. doi:10.1056/NEJMoa1001593. 2Rocco MV, Lockridge RS, Beck GJ, et al. The effects of frequent nocturnal home hemodialysis: the Frequent Hemodialysis Network Nocturnal Trial. Kidney Int. 2011;80(10):1080-1091. doi:10.1038/ki.2011.213. 3Culleton BF, Walsh M, Klarenbach SW, et al. Effect of frequent nocturnal hemodialysis vs conventional hemodialysis on left ventricular mass and quality of life: a randomized controlled trial. JAMA. 2007;298(11):1291- 1299. doi:10.1001/jama.298.11.1291. Multiple randomized clinical trials show intensive hemodialysis significantly lowers blood pressure.1,2,3 CHAPTER 2, FIGURE 2: Effects of intensive versus conventional hemodialysis on pre-dialysis systolic blood pressure in the FHN Daily Trial,1 the FHN Nocturnal Trial,2 and the Canadian trial of nocturnal hemodialysis.3 Estimated treatment effects (solid dots) and associated 95% confidence intervals (solid lines) are displayed at the bottom. -10 mmHg -11 mmHg -8 mmHg AdvancingDialysis.org
  • 4. . 1Kotanko P, Garg AX, Depner T, et al. Effects of frequent hemodialysis on blood pressure: Results from the randomized frequent hemodialysis network trials. Hemodial Int Int Symp Home Hemodial. 2015;19(3):386-401. doi:10.1111/hdi.12255. 2Culleton BF, Walsh M, Klarenbach SW, et al. Effect of frequent nocturnal hemodialysis vs. conventional hemodialysis on left ventricular mass and quality of life: a randomized controlled trial. JAMA. 2007;298(11):1291-1299. doi:10.1001/jama.298.11.1291. In the FHN Daily Trial, the number of antihypertensive medications per patient declined from 2.2 to 1.4.1 In trials of nocturnal hemodialysis, the number of antihypertensive medications per patients decreased similarly.2 CHAPTER 2, FIGURE 3: Mean number of prescribed antihypertensive medications at baseline, at month 4, and at month 12 of the FHN Daily Trial.1 Dashed bars span one standard deviation above and below the mean. 36%DECREASE AT MONTH 12 AdvancingDialysis.org