Hypertension in dialysis-dependent patients: Pathophysiology, monitoring, and evidence-based management strategies

Abstract

Hypertension is a common and challenging complication in dialysis-dependent patients, contributing significantly to cardiovascular morbidity and mortality in this population. This paper explores the pathophysiology of hypertension in end-stage renal disease (ESRD), emphasizing the roles of volume overload, activation of the renin-angiotensin-aldosterone system (RAAS), and sympathetic nervous system hyperactivity. It also discusses the challenges of accurate blood pressure monitoring in dialysis patients and reviews evidence-based management strategies, including pharmacological and non-pharmacological interventions. Additionally, this study incorporates primary data collected from dialysis-dependent patients at SKIMS Soura, providing observational insights and clinical readings. By integrating current evidence, clinical guidelines, and primary data, this study aims to provide a comprehensive framework for optimizing blood pressure control in dialysis-dependent patients, ultimately improving cardiovascular outcomes and quality of life.