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Hypertension and Cardiovascular Aspects of Dialysis Treatment - Clinical management of volume control

Hypertension and Cardiovascular Aspects of Dialysis Treatment - Clinical management of volume control

von: Branko Braam, Kailash Jindal, Evert J. Dorhout Mees

Pabst Science Publishers, 2011

ISBN: 9783899677218 , 192 Seiten

Format: PDF

Kopierschutz: DRM

Windows PC,Mac OSX Apple iPad, Android Tablet PC's

Preis: 15,99 EUR

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Hypertension and Cardiovascular Aspects of Dialysis Treatment - Clinical management of volume control


 

Table of contents

6

Preface

10

Foreword to the first edition „Cardiovascular aspects of dialysis treatment“

11

Preface to the first edition „Cardiovascular aspects of dialysis treatment“ by Evert J. Dorhout-Mees

12

1. Synopsis of the physiological regulation of extracellular fluid volume and blood pressure

15

1.1 Water, salt and body fluid volumes

15

1.2 Regulating mechanisms of osmolality and ECV in normal man

20

1.3 The relationship between extracellular fluid volume, blood volume and blood pressure

23

1.4 The renal function curve

26

Summary

27

Bibliography

27

2. End stage renal disease

28

2.1 The aim of dialysis treatment

28

2.2 When is dialysis treatment adequate

29

2.3 The KT/V concept and its limitation

32

2.4 Control of the extracellular fluid volume in dialysis patients

33

2.5 Consequences of extracellular fluid volume expansion

37

2.6 The dry weight concept

42

2.7 Assessment of the volume status in hemodialysis patients

44

Summary

49

Bibliography

49

3. Hypertension and survival in dialysis patients

52

3.1 Prevalence of hypertension

52

3.2 Which blood pressure is representative?

54

3.3 Hypertension and survival

55

3.4 What is the optimal blood pressure?

58

Summary

59

Bibliography

60

4. Pathophysiology of Hypertension in dialysis patients

61

4.1 Volume expansion is the key

61

4.2 The renin-angiotensin system

67

4.3 The Sympathetic Nervous System

70

4.4 Other hypertensive mechanisms

71

4.5 Paradoxical hypertension

72

Summary

73

Bibliography

74

5. Treatment of Hypertension in dialysis patients

75

5.1 General strategies for volume control

75

5.2 Decreasing salt intake

75

5.3 Conventional hemodialysis and volume balance

76

5.4 Increasing volume removal by frequency of dialysis sessions

76

5.5 Increasing volume removal by increasing ultrafiltration duration

78

5.6 Antihypertensive drugs

79

5.7 Diuretic use in dialysis patients

81

Summary

82

Bibliography

82

6. Dialysis Hypotension

83

6.1 General considerations

83

6.2 Symptoms of dialysis hypotension

84

6.3 Pathogenesis of dialysis hypotension

86

6.4 True hypovolemia

86

6.5 The dialysis procedure

91

6.6 The ‘uremic state’: Are circulatory responses to the decrease in blood volume disturbed?

94

6.7 Cardiac functions

94

6.8 Concluding remarks regarding intradialytic hypotension

96

6.9 Sustained chronic hypotension

98

Summary

99

Bibliography

100

7. Heart disease in dialysis patients

102

7.1 General considerations, risk factors

102

7.2 Methods of investigation

103

7.3 Cardiac Dilatation

110

7.4 Left ventricular hypertrophy

111

7.5 Congestive heart failure

118

7.6 Valvular disease

121

7.7 Dilated cardiomyopathy of end-stage renal disease

124

7.8 Sudden Cardiac Death (SCD) and Arrhytmias

129

Summary

131

Bibliography

132

8. Vascular disease in dialysis patients

134

8.1 Ischemic heart disease

134

8.2 Arterial stiffening and systolic hypertension

137

8.3 Peripheral artery disease

142

8.4 Stroke

142

8.5 Venous changes

143

Summary

143

Bibliography

143

9. Peritoneal Dialysis

145

9.1 Introduction

145

9.2 Cardiovascular complications and risk factors

146

9.3 Hemodynamic and cardiac status

147

9.4 Treatment of overhydration in peritoneal dialysis patients

149

9.5 Why does peritoneal dialysis not provide better cardiovascular results?

152

9.6 Lack of volume control

153

Summary

154

Bibliography

155

10. Special considerations

156

10.1 Effusions in serous cavities

156

Summary

161

10.2 Renal anemia and erythropoietin therapy

161

10.3 Malnutrition in ESRD

167

10.4 Recent views about sensing, distribution and cellular actions of salt

172

Summary

175

Bibliography

176

11. Final considerations and future perspectives

178

11.1 Quality of life

178

11.2 Evidence-based medicine and controlled trials

180

11.3 Care of the dialysis patient by the dialysis team

181

11.4 Practical considerations

182

11.5 Future perspectives

183

11.6 Pathophysiological problems in hemodialysis research to be resolved

185

11.7 Comeback of clinical research

187

Bibliography

187

Index

189