ISSN: 1305-385X
Hakkında: Özel sayılar şeklinde yayınlanır.
|
|
|
Hypertension In Chronic Renal Failure And Its Treatment
Dr. Pırıl SAĞLIKER ÖZKAYNAK,a Dr. Hasan Sabit SAĞLIKER,a Dr. Yahya SAĞLIKERa
aİç Hastalıkları AD, Nefroloji BD, Çukurova Üniversitesi Tıp Fakültesi, ADANA
The optimal upper limit value suggested for non-complicated hypertension is 135/85 mmHg. Lower values may need to be targeted in chronic renal failure but excessively low values should be avoided. When systolic blood pressure is considered, pre- and post-dialysis patients with pressures less than 120 mmHg and pre-dialysis patients with pressures higher than 180 mmHg have been found to have increased morbidity and mortality. It is well known that salt and water retention and renin-angiotensin-aldosterone system (RAAS) activation have leading roles in the pathophysiology of hypertension accompanying renal failure. It is thus sensible to apply salt and water restriction as well as intensive dialysis regimens to eliminate excess salt and water and to prefer ACEIs ve ARBs in addition to calcium channel blockers and diuretics in the treatment protocols of patients with chronic renal failure and hypertension. For hypertensive patients with renal transplants, sirolimus may be more preferable than other immunosuppresive agents because of its decreased tendency to cause hypertension. In this article, pathophysiologic mechanisms and treatment principles of hypertension accompanying chronic renal failure will be reviewed.Keywords: Blood pressure, hypertension, chronic renal failure, diabetic nephropathy, transplantation hypertensionTurkiye Klinikleri J Int Med Sci 2005, 1(38):110-114
|
|
|
|
|
