How high blood pressure in hemodialysis patients should be diagnosed and treated using
medications or without medications is the purpose of this study.
- Adults with hypertension on hemodialysis Hypertensive, long-term (3 months or more)
hemodialysis patients will be studied over a 6 hemodialysis baseline phase during which
44-hour interdialytic ambulatory BP will be performed and baseline symptoms collected.
Patients with well-controlled hypertension, on anti-hypertensive therapy will have blood
pressure medications withdrawn until they become hypertensive as assessed by 44-hour
interdialytic ambulatory blood pressure recording. We will exclude patients who have had
vascular event (stroke, myocardial infarction or limb ischemia requiring bypass) within
previous six months, ambulatory BP >170 mm Hg systolic or >100 mm Hg diastolic, those who
miss 2 or more hemodialysis treatments in the previous month, abuse street-drugs, require
home oxygen, have symptomatic congestive heart failure or are morbidly obese (body mass
index > 40 kg/m2).