By E.J. Dorhout Mees
Cardiovascular issues are usually not in basic terms answerable for greater than 1/2 our sufferers' mortality, in addition they characterize the majority of daily difficulties in a dialysis unit. but, the gap allotted to them within the significant textbooks covers purely 2-8% in their overall content material. The origins of this booklet lie in lots of years of daily care of dialysis sufferers. It steadily turned transparent to the writer that methodical software of recognized pathophysiological rules may enhance sufferers' stipulations past expectancies. extra importantly, it seemed that global literature was once in general keen on comparing chance elements and that efforts to enhance diagnosis have been focused on urea removing. it is necessary, hence, to note that `Volume Control', the principal factor of this ebook, isn't integrated into the `Adequacy' suggestion. whereas basically meant for dialysis medical professionals, the writer in actual fact hopes that dialysis nurses, who hold the lion's proportion of daily accountability for dialysis sufferers, also will locate this publication an invaluable and useful consultant to dialysis treatment.
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Extra resources for Cardiovascular Aspects of Dialysis Treatment: The importance of volume control
Other blood-pressure-increasing factors, notably increased sympathetic activity, are present in dialysis patients, but their role in blood pressure regulations is not yet clear. 'Paradoxical' hypertension during dialysis is often due to overhydration and cardiac dilatation. Antihypertensive drug treatment is mostly ineffective in dialysis patients because these drugs cannot correct volume overload. Bibliography Agarwal I R.
1992). All of the patients (58% of the total) who were treated with long dialysis sessions in a center in the UK had normal BP (116/67) without drugs (Goldsmith et al. 1997). A Turkish center reported a mean BP of 131/80 ± 17/9 in all 67 patients treated with strict volume control during one year (Ozkahya et al. 1999 (Ch. 5)). The most impressive results were obtained in Tassin (France) where BP could be normalized in 97% of the 712 patients (Carra et al. 1992). The failure to achieve BP control by the great majority of dialysis centers around the world has led to speculation that the present-day type of patients ('case mix') is different from the past and also varies between populations.
CARDIOVASCULAR ASPECTS OF DIALYSIS TREATMENT 31 In sharp contrast, a group of investigators (Charra et al. 2). These diverging results seem rather confusing. Yet despite the fact that most of these studies accounted for other risk factors and used sophisticated statistical analyses, it is clear that confounding factors must have caused these discrepancies. 3). It is well known that heart failure is associated with decrease in blood pressure. It was shown recently that the Tor IU' curve seen in elderly patients with essential hypertension can be explained by the fact that previously high BP decreases before the patient dies from heart failure.