Hemodialysis Can Cause Hypertension and How to Deal with It

Hemodialysis is the main therapy for the patients with End Stage Renal Failure. During dialysis process, the patients’ uremic symptoms have improvement obviously. However, hemodialysis can not replace the native kidneys totally and also it may cause many complications. Hypertension is a common complication for the patients on hemodialysis, which is a risky factor of cardiovascular complications. A good control of blood pressure can alleviate and delay atherosclerosis thus decreasing the incidence of cardiovascular complications and their death rate so as to prolong their life expectancy. Therefore, it is very necessary for the patients on hemodialysis to know the causes of hypertension and how to deal with it.

1. Increased volume load

Hemodialysis can accelerate the decline of the residual renal function thus causing urine output to decline. Therefore, if the patients can not keep a proper diet and have inadequate dialysis, it is very likely to cause severe volume load.

2. Renin-angiotensin-aldosterone system

For some patients with hypertension, although they have adequate dialysis and control their dry body weight, it is still very hard for them to control their blood pressure within the normal range. What’s worse, the more serious dehydration is, the higher blood pressure will be. However, excision of kidneys can help decline blood pressure. It proves that renin-angiotensin-aldosterone system can plays an important role in regulating blood pressure.

3. Application of EPO

In body, more than 90% of EPO is secreted by kidneys. As kidneys are damaged, less EPO is secreted, which is the main cause of renal anemia. The application of recombinant human erythropoietin becomes the main measure in treating anemia. However, EPO has a direct function in contracting blood vessels.

As hypertension is an important factor in causing cardiovascular complications and death, it is very important for the patients on hemodialysis to take measures to deal with it.

The patients on hemodialysis should have adequate dialysis. It can help decrease the retention of water and sodium thus benefiting the control of hypertension.

1. Keep standard dry body weight

When starting hemodialysis, the patients should remove the excessive fluid in body gradually. Within 6~8 weeks, they should reach their standard dry body weight so as to avoid hypotension and cramp.

2. Limit sodium intake

The sodium intake should not exceed 6 grams per day. Meanwhile, the sodium concentration in dialysis fluid should also be decreased.

3. Switch to hemofiltration

Hemofiltration can control body fluid better than hemodialysis and also can remove some middle molecular substances relative to hypertension. Therefore, if the refractory hypertension, they can switch to hemofiltration.


If the patients can follow the above tips and treat hypertension effectively, they will be able to reduce the damage to them. If you want to get more suggestion on how to control high blood pressure, on diet, therapy or some other aspects, please consult on line or email to kidney-treatment@hotmail.com.