0
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found

      Volume Control, Blood Pressure and Cardiovascular Function

      Read this article at

      ScienceOpenPublisherPubMed
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          The balance of sodium, through its dietary intake and renal excretion, determines extracellular fluid volume (ECV). Chronic renal failure and dialysis patients present with a positive sodium balance and increased ECV. The consequences are systemic hypertension and vascular and cardiac remodelling, especially left ventricular hypertrophy (LVH). High blood pressure (BP) and LVH increase the mortality risk of dialysis patients. Correction of ECV overload with ultrafiltration has led to the dry weight concept, which is the postdialysis body weight that allows BP to remain normal until the next dialysis session, without the need for antihypertensive medication and despite interdialytic weight gain. Blood pressure is the key indicator of ECV and is used to set the body weight target at each dialysis session. Normalization of BP indicates normalization of ECV, usually with a lag-time. Shortening dialysis time, which increases intradialytic morbidity, compromises the achievement of dry weight and normalization of ECV. Such intradialytic events may also lead to an increase in dialysate sodium concentration, which causes thirst, and greater interdialytic weight gain, positive sodium balance and worsening BP. These complications have led to the development of other tools for ECV assessment, such as inferior vena cava diameter, bioimpedance, and blood volume monitoring; their usefulness is discussed.

          Related collections

          Most cited references 8

          • Record: found
          • Abstract: found
          • Article: not found

          Blood pressure and end-stage renal disease in men.

          End-stage renal disease in the United States creates a large burden for both individuals and society as a whole. Efforts to prevent the condition require an understanding of modifiable risk factors. We assessed the development of end-stage renal disease through 1990 in 332,544 men, 35 to 57 years of age, who were screened between 1973 and 1975 for entry into the Multiple Risk Factor Intervention Trial (MRFIT). We used data from the national registry for treated end-stage renal disease of the Health Care Financing Administration and from records on death from renal disease from the National Death Index and the Social Security Administration. During an average of 16 years of follow-up, 814 subjects either died of end-stage renal disease or were treated for that condition (15.6 cases per 100,000 person-years of observation). A strong, graded relation between both systolic and diastolic blood pressure and end-stage renal disease was identified, independent of associations between the disease and age, race, income, use of medication for diabetes mellitus, history of myocardial infarction, serum cholesterol concentration, and cigarette smoking. As compared with men with an optimal level of blood pressure (systolic pressure or = 210 mm Hg or diastolic pressure > or = 120 mm Hg) was 22.1 (P < 0.001). These relations were not due to end-stage renal disease that occurred soon after screening and, in the 12,866 screened men who entered the MRFIT study, were not changed by taking into account the base-line serum creatinine concentration and urinary protein excretion. The estimated risk of end-stage renal disease associated with elevations of systolic pressure was greater than that linked with elevations of diastolic pressure when both variables were considered together. Elevations of blood pressure are a strong independent risk factor for end-stage renal disease; interventions to prevent the disease need to emphasize the prevention and control of both high-normal and high blood pressure.
            Bookmark
            • Record: found
            • Abstract: not found
            • Article: not found

            Plasma concentration of asymmetrical dimethylarginine and mortality in patients with end-stage renal disease: a prospective study

              Bookmark
              • Record: found
              • Abstract: not found
              • Article: not found

              Hemodialysis for chronic renal failure. Clinical observations.

                Bookmark

                Author and article information

                Journal
                NEP
                Nephron Physiol
                10.1159/issn.1660-2137
                Nephron Physiology
                S. Karger AG
                1660-2137
                2003
                April 2003
                09 May 2003
                : 93
                : 4
                : p94-p101
                Affiliations
                Centre de Rein Artificiel, Tassin, France
                Article
                70242 Nephron Physiol 2003;93:p94–p101
                10.1159/000070242
                12759570
                © 2003 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                References: 40, Pages: 1
                Product
                Self URI (application/pdf): https://www.karger.com/Article/Pdf/70242
                Categories
                Minireview

                Comments

                Comment on this article