Katarína Bobocká, Jozef Kalužay, Peter Ponťuch
Arterial hypertension occurs in 80 - 90 % patients at the beginning of dialysis and mostly is associated with organ damage. Inadequate control of arterial hypertension is the main cause of left ventricular hypertrophy, cardiovascular morbidity and mortality. It is important to know that each increase in mean arterial blood pressure is correlated independently with the development of ischemic heart disease de novo and congestive heart failure. Patients with chronic kidney disease (CKD) have a death rate much more higher compared with the patients of the same age without CKD. The control of blood pressure is the highest priority in haemodialysed patient, but there is still high percentage of patients with inadequate values of blood pressure. Arterial hypertension is an important predictor of coronary artery disease in uremic patients, similarly as chronic nicotinism, or hypertriglyceridaemia. A non-pharmacologic approach – setup and maintenance of dry weight, restriction of daily natrium and water intake is cardinal in the management of arterial hypertension. In a pharmacological approach it is necessary to consider the elimination of antihypertensive drugs during the haemodialysis. ACE-inhibitors and angiotensin receptors blockers are preferred antihypertensive agents.