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Том 22 №2 2020 год - Нефрология и диализ

Артериальная гипертензия при ХБП: от начальных до продвинутых стадий. Диагностические и терапевтические стратегии. Часть 2. Заместительная почечная терапия (программный гемодиализ)

Зелтынь-Абрамов Е.М. Земченков А.Ю.

DOI: 10.28996/2618-9801-2020-2-237-251

Аннотация: Статья посвящена актуальным вопросам диагностики и лечения артериальной гипертензии (АГ) у пациентов на программном гемодиализе (ПГД). Анализируются особенности патогенеза формирования и прогрессирования АГ, присущие диализной популяции: персистирующая перегрузка объемом, задержка натрия, колебания волемического статуса, прогрессирующая артериальная жесткость. Подчеркивается необходимость учета клинической значимости других причин АГ: перманентной гиперсимпатикотонии, сохраняющейся гиперактивности ренин-ангиотензин-альдостероновой системы. Важно учитывать побочные эффекты эритропоэз-стимулирующих препаратов, наличие у пациентов синдрома обструктивного апноэ сна. На основании данных многочисленных рандомизированных клинических исследований (РКИ), ряда согласительных документов и рекомендаций, представлены современные подходы к лечению АГ. Нефармакологические методы базируются на совершенствовании диализных и диетических стратегий, направленных на контроль волемии, предотвращение задержки натрия, достижения и удержания оптимального сухого веса. Перспективным представляется изменение стандартной процедуры ПГД в виде увеличения кратности или пролонгации диализных сессий, коррекция содержания натрия в диализном растворе в зависимости от его концентрации в плазме пациента. С точки зрения повышения эффективности диетических стратегий внимание уделяется приверженности пациентов к модификации образа жизни с учетом их психологических и социально-экономических предпочтений. Медикаментозное лечение АГ подразумевает использование современных классов гипотензивных препаратов с учетом влияния ПГД на их фармакокинетику. Обсуждаются необходимые для адекватного контроля АГ диагностические модальности - Эхо-КГ - мониторинг для реалистической оценки гипертрофии левого желудочка, биоимпедансные исследования для этапного контроля сухого веса и УЗИ легких для объективизации перегрузки объемом. Среди дальнейших направлений указывается необходимость продолжения проведения масштабных РКИ для определения целевых показателей АГ и объективизации эффективности существующих методов лечения. В качестве расширения терапевтических и хирургических возможностей предлагается уделить внимание гипотензивным препаратам центрального действия, денервации почек, эмболизации почечных артерий и билатеральной нефрэктомии.

Для цитирования: Зелтынь-Абрамов Е.М., Земченков А.Ю. Артериальная гипертензия при ХБП: от начальных до продвинутых стадий. Диагностические и терапевтические стратегии. Часть 2. Заместительная почечная терапия (программный гемодиализ). Нефрология и диализ. 2020. 22(2):237-251. doi: 10.28996/2618-9801-2020-2-237-251

Весь текст

Ключевые слова: хроническая болезнь почек, гемодиализ, артериальная гипертензия, кардиоваскулярные риски, перегрузка объемом, задержка натрия, диализные стратегии, диетические ограничения, артериальная жесткость, chronic kidney disease, hemodialysis, hypertension, cardiovascular risks, volume overload, sodium retention, dialysis strategies, salt restriction, arterial stiffness

Список литературы:

1. Agarwal R., Nissenson A.R., Batlle D. et al. Prevalence, treatment, and control of hypertension in chronic hemodialysis patients in the United States. Am J Med. 2003; 115(4): 291-97. doi: 10.1016/s0002-9343(03)00366-8.
2. Sarafidis P.A., Persu A., Agarwal R. et al. Hypertension in dialysis patients: A consensus document by the European Renal and Cardiovascular Medicine (EURECA-m) working group of the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) and the Hypertension and the Kidney Working Group of the European Society of Hypertension (ESH). Nephrol Dial Transplant, 2017; 32(4): 620-4. doi: 10.1093/ndt/gfw433.
3. Sarafidis P.A., Bakris G.L. Kidney disease and hypertension. In: G Lip, J Hall, eds. Comprehensive Hypertension. London: Mosby Elsevier, 2007, 607-619.
4. Zoccali C., Moissl U., Chazot C. et al. Chronic fluid overload and mortality in ESRD. J Am Soc Nephrol. 2017; 28: 2491-2497. doi: 10.1681/ASN.2016121341.
5. Flythe JE, Bansal N. The relationship of volume overload and its control to hypertension in hemodialysis patients. Semin Dial. 2019;32(6):500-506. doi:10.1111/sdi.12838.
6. Dahlmann A., Dörfelt K., Eicher F. et al. Magnetic resonance-determined sodium removal from tissue stores in hemodialysis patients. Kidney Int. 2015; 87: 434-441. doi: 10.1038/ki.2014.269.
7. Kopp C., Linz P., Maier C. et al. Elevated tissue sodium deposition in patients with type 2 diabetes on hemodialysis detected by (23)Na magnetic resonance imaging. Kidney Int. 2018; 93: 1191-1197. doi: 10.1016/j.kint.2017.11.021.
8. Kopp C., Linz P., Dahlmann A. et al. 23Na magnetic resonance imaging-determined tissue sodium in healthy subjects and hypertensive patients. Hypertension. 2013; 61: 635-640. doi: 10.1161/HYPERTENSIONAHA.111.00566.
9. Oparil S., Zaman M.A., Calhoun D.A. Pathogenesis of hypertension. Ann Intern Med. 2003; 139: 761-776. doi: 10.7326/0003-4819-139-9-200311040-00011.
10. Hall J. E. The renin-angiotensin system: renal actions and blood pressure regulation. Compr Ther 1991; 17: 8-17.
11. Ritz E., Fliser D. The kidney in congestive heart failure. Eur Heart J 1991; 12(SupplC): 14-20.
12. Wiig H., Schroder A., Neuhofer W. et al. Immune cells control skin lymphatic electrolyte homeostasis and blood pressure. J Clin Invest 2013; 123: 2803-2815. doi: 10.1172/JCI60113.
13. Dahlmann A., Dorfelt K., Eicher F. et al. Magnetic resonance-determined sodium removal from tissue stores in hemodialysis patients. Kidney Int 2015; 87: 434-441.
14. McCullough P. A., Chan C. T., Weinhandl E. D. et al. Intensive Hemodialysis, Left Ventricular Hypertrophy, and Cardiovascular Disease. American Journal of Kidney Diseases. 201668 (5), S5-S14. doi:10.1053/j.ajkd.2016.05.025.
15. Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of, Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2016; 17(4): 412. doi:10.1093/ehjci/jew041.
16. Briet M., Boutouyrie P., Laurent S. et al. Arterial stiffness and pulse pressure in CKD and ESRD. Kidney Int 2012; 82: 388-400.
17. London G.M. Arterial Stiffness in Chronic Kidney Disease and End-Stage Renal Disease. Blood Purif. 2018; 45(1-3):154-158. doi:10.1159/000485146.
18. Georgianos P.I., Sarafidis P.A., Lasaridis A.N. Arterial stiffness: a novel cardiovascular risk factor in kidney disease patients. Curr Vasc Pharmacol 2015; 13: 229-238.
19. Agarwal R., Light R.P. Arterial stiffness and interdialytic weight gain influence ambulatory blood pressure patterns in hemodialysis patients. Am J Physiol Renal Physiol 2008; 294: F303-F308.
20. Georgianos P.I., Agarwal R. Aortic stiffness, ambulatory blood pressure, and predictors of response to antihypertensive therapy in hemodialysis. Am J Kidney Dis 2015; 66: 305-312.
21. Karpetas A., Sarafidis P.A., Georgianos P.I. et al. Ambulatory recording of wave reflections and arterial stiffness during intra- and interdialytic periods in patients treated with dialysis.Clin J Am Soc Nephrol 2015; 10: 630-638.
22. Koutroumbas G., Georgianos P.I., Sarafidis P.A. et al. Ambulatory aortic blood pressure, wave reflections and pulse wave velocity are elevated during the third in comparison to the second interdialytic day of the long interval in chronic haemodialysis patients. Nephrol Dial Transplant 2015; 30: 2046-2053.
23. Hausberg M., Kosch M., Harmelink P. et al. Sympathetic nerve activity in endstage renal disease. Circulation, 2002; 106(15): 1974-79. doi: 10.1161/01.cir.0000034043.16664.96.
24. Di Daniele N., De Francesco M., Violo L. et al. Renal sympathetic nerve ablation for the treatment of difficult-to-control or refractory hypertension in a haemodialysis patient. Nephrol Dial Transplant, 2012; 27(4): 1689-90. doi: 10.1093/ndt/gfs044.
25. Xu J., Li G., Wang P. Et al. Renalase is a novel, soluble monoamine oxidase that regulates cardiac function and blood pressure. J. Clin. Investig. 2005; 115: 1275-1280. doi: 10.1172/JCI24066.
26. Li G., Xu J., Wang P. Et al. Catecholamines regulate the activity, secretion, and synthesis of renalase. Circulation. 2008; 117: 1277-1282. doi: 10.1161/CIRCULATIONAHA.107.732032.
27. Desir G.V., Peixoto A.J. Renalase in hypertension and kidney disease. Nephrol. Dial. Transplant. 2014;29:22-28. doi: 10.1093/ndt/gft083.
28. Desir G.V. Renalase deficiency in chronic kidney disease, and its contribution to hypertension and cardiovascular disease. Curr. Opin. Nephrol. Hypertens. 2008; 17:181-185. doi: 10.1097/MNH.0b013e3282f521ba.
29. Bazzato G., Coli U., Landini S. et al. Prevention of intra- and postdialytic hypertensive crises by captopril. Contrib Nephrol 1984; 41: 292-298. doi: 10.1159/000429299.
30. Henrich W.L., Katz F., Molinoff P.B. et al. Competitive effects of hypokalemia and volume depletion on plasma renin activity, aldosterone and catecholamine concentrations in hemodialysis patients. Kidney Int 1977; 12: 279-284. doi: 10.1038/ki.1977.112.
31. Tada T., Kusano K.F., Ogawa A. et al. The predictors of central and obstructive sleep apnoea in haemodialysis patients. Nephrol Dial Transplant 2007; 22: 1190-1197. doi: 10.1093/ndt/gfl748.
32. Ogna A., Forni O.V., Mihalache A. et al. Obstructive sleep apnea severity and overnight body fluid shift before and after hemodialysis. Clin J Am Soc Nephrol 2015; 10:1002-1010. doi: 10.2215/CJN.08760914.
33. Zoccali C., Benedetto F.A., Tripepi G. et al. Nocturnal hypoxemia, night-day arterial pressure changes and left ventricular geometry in dialysis patients. Kidney Int 1998; 53:1078-1084. doi: 10.1111/j.1523-1755.1998.00853.x.
34. Abdel-Kader K., Dohar S., Shah N. et al. Resistant hypertension and obstructive sleep apnea in the setting of kidney disease. J Hypertens 2012; 30: 960-966. doi: 10.1097/HJH.0b013e328351d08a.
35. Boyle S.M., Berns J.S. Erythropoietin and resistant hypertension in CKD. Semin Nephrol 2014; 34: 540-549. doi: 10.1016/j.semnephrol.2014.08.008.
36. Carlini R.G., Dusso A.S., Obialo C.I. et al. Recombinant human erythropoietin (rHuEPO) increases endothelin-1 release by endothelial cells. Kidney Int 1993; 43: 1010-1014. doi: 10.1038/ki.1993.142.
37. Kang D.H., Yoon K.I., Han D.S. Acute effects of recombinant human erythropoietin on plasma levels of proendothelin-1 and endothelin-1 in haemodialysis patients. Nephrol Dial Transplant 1998; 13: 2877-2883. doi: 10.1093/ndt/13.11.2877.
38. Eggena P., Willsey P., Jamgotchian N. et al. Influence of recombinant human erythropoietin on blood pressure and tissue renin-angiotensin systems. Am J Physiol 1991; 261: E642-E646. doi: 10.1152/ajpendo.1991.261.5.E642.
39. Hand M.F., Haynes W.G., Johnstone H.A. et al. Erythropoietin enhances vascular responsiveness to norepinephrine in renal failure. Kidney Int 1995; 48:806-813. doi: 10.1038/ki.1995.354.
40. Koulouridis I., Alfayez M., Trikalinos T.A. et al. Dose of erythropoiesis stimulating agents and adverse outcomes in CKD: a metaregression analysis. Am J Kidney Dis 2013; 61:44-56. doi: 10.1053/j.ajkd.2012.07.014.
41. Phrommintikul A., Haas S.J., Elsik M. et al. Mortality and target haemoglobin concentrations in anaemic patients with chronic kidney disease treated with erythropoietin: a meta-analysis. Lancet 2007; 369:381-388. doi: 10.1016/S0140-6736(07)60194-9.
42. Сабодаш А.Б., Салихова К.А., Земченков Г.А. и соавт. Динамика артериальной гипертензии и выживаемость у пациентов на гемодиализе. Нефрология и диализ. 2016; 18(4):416-430.
43. Williams B., Mancia G., Spiering W., ESC Scientific Document Group. 2018 ESC/ESH guidelines for the management of arterial hypertension. Eur Heart J. 2018; 39(33): 3021-104.
44. Parati G., Ochoa J.E., Bilo G. et al. Hypertension in Chronic Kidney Disease Part 1: Out-of-Office Blood Pressure Monitoring: Methods, Thresholds, and Patterns. Hypertension. 2016;67(6):1093-1101. doi:10.1161/HYPERTENSIONAHA.115.06895.
45. Georgianos P.I., Agarwal R. Blood Pressure and Mortality in Long-Term Hemodialysis-Time to Move Forward. Am J Hypertens 2017; 30(3):211-22. doi: 10.1093/ajh/hpw114.
46. Agarwal R. Blood pressure and mortality among hemodialysis patients. Hypertension 2010; 55:762-8. doi: 10.1161/HYPERTENSIONAHA.109.144899.
47. Lewington S., Clarke R., Qizilbash N. et al. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002; 360: 1903-1913. doi: 10.1016/s0140-6736(02)11911-8.
48. Li Z., Lacson E. Jr, Lowrie E.G. et al. The epidemiology of systolic blood pressure and death risk in hemodialysis patients. Am J Kidney Dis. 2006; 48: 606-615. doi: 10.1053/j.ajkd.2006.07.005.
49. Port F.K., Hulbert-Shearon T.E., Wolfe R.A. et al. Predialysis blood pressure and mortality risk in a national sample of maintenance hemodialysis patients. Am J Kidney Dis 1999; 33:507-517. doi: 10.1016/s0272-6386(99)70188-5.
50. Salem M.M. Hypertension in the haemodialysis population: any relationship to 2-years survival? Nephrol Dial Transplant 1999;1 4: 125-128. doi: 10.1093/ndt/14.1.125.
51. Zager P.G., Nikolic J., Brown R.H. et al. “U” curve association of blood pressure and mortality in hemodialysis patients. Medical Directors of Dialysis Clinic, Inc. Kidney Int 1998; 54: 561-569. doi: 10.1046/j.1523-1755.1998.00005.x.
52. Hannedouche T., Roth H., Krummel T. et al. Multiphasic effects of blood pressure on survival in hemodialysis patients. Kidney Int 2016; 90: 674-684. doi: 10.1016/j.kint.2016.05.025.
53. Bansal N, McCulloch CE, Rahman M, et al, CRIC Study Investigators. Blood pressure and risk of all-cause mortality in advanced chronic kidney disease and hemodialysis: the chronic renal insufficiency cohort study. Hypertension 2015; 65(1):93-100. doi: 10.1161/HYPERTENSIONAHA.114.04334.
54. Bansal N, McCulloch CE, Lin F et al, CRIC Study Investigators. Blood Pressure and Risk of Cardiovascular Events in Patients on Chronic Hemodialysis: The CRIC Study (Chronic Renal Insufficiency Cohort). Hypertension. 2017;70(2):435-443. doi: 10.1161/HYPERTENSIONAHA.117.09091.
55. Klassen P.S., Lowrie E.G., Reddan D.N. et al. Association between pulse pressure and mortality in patients undergoing maintenance hemodialysis. JAMA 2002; 287:1548-1555. doi: 10.1001/jama.287.12.1548.
56. Foley R.N., Herzog C.A., Collins A.J. Blood pressure and long-term mortality in United States hemodialysis patients: USRDS Waves 3 and 4 Study. Kidney Int 2002; 62:1784-1790. doi: 10.1046/j.1523-1755.2002.00636.x.
57. Dekker M., Konings C., Canaud B. et al. Pre-dialysis fluid status, pre-dialysis systolic blood pressure and outcome in prevalent haemodialysis patients: results of an international cohort study on behalf of the MONDO initiative. Nephrol Dial Transplant. 2018;33(11):2027-2034. doi: 10.1093/ndt/gfy095.
58. Cabrera C., Brunelli S.M., Rosenbaum D. et al. A retrospective, longitudinal study estimating the association between interdialytic weight gain and cardiovascular events and death in hemodialysis patients. BMC Nephrol. 2015; 16:11. doi: 10.1186/s12882-015-0110-9.
59. Wabel P., Moissl U., Chamney P. et al. Towards improved cardiovascular management: the necessity of combining blood pressure and fluid overload. Nephrol Dial Transplant. 2008; 23: 2965-2971. doi: 10.1093/ndt/gfn228.
60. McGee S., Abernethy W.B. 3rd, Simel D.L. The rational clinical examination. Is this patient hypovolemic? JAMA 1999; 281: 1022-1029. doi: 10.1001/jama.281.11.1022.
61. Agarwal R., Weir M.R. Dry-weight: a concept revisited in an effort to avoid medication-directed approaches for blood pressure control in hemodialysis patients. Clin J Am Soc Nephrol 2010; 5:1255-1260. doi: 10.2215/CJN.01760210.
62. Sinha A.D., Agarwal R. Can chronic volume overload be recognized and prevented in hemodialysis patients? The pitfalls of the clinical examination in assessing volume status. Semin Dial 2009; 22: 480-482. doi: 10.1111/j.1525-139X.2009.00641.x.
63. Tangvoraphonkchai K., Davenport A. Extracellular water excess and increased self-reported fatigue in chronic hemodialysis patients. Ther Apher Dial. 2018; 22: 152-159. doi: 10.1111/1744-9987.12648.
64. Agarwal R., Alborzi P., Satyan S. et al. Dry-weight reduction in hypertensive hemodialysis patients (DRIP): a randomized, controlled trial. Hypertension 2009; 53: 500-507. doi: 10.1161/HYPERTENSIONAHA.108.125674.
65. Agarwal R., Bouldin J.M., Light R.P. et al. Probing dry-weight improves left ventricular mass index. Am J Nephrol 2011; 33: 373-380. doi: 10.1159/000326235.
66. Movilli E., Camerini C., Gaggia P. et al. Magnitude of end-dialysis overweight is associated with all-cause and cardiovascular mortality: a 3-year prospective study. Am J Nephrol. 2013; 37: 370-377. doi: 10.1159/000349931.
67. Scribner B.H., Buri R., Caner J.E. et al. The treatment of chronic uremia by means of intermittent hemodialysis: a preliminary report. Trans Am Soc Artif Intern Organs. 1960; 6: 114-122.
68. Tattersall J., Martin-Malo A., Pedrini L. et al. EBPG guideline on dialysis strategies. Nephrol Dial Transplant 2007; 22 (Suppl2):ii5-ii21. doi: 10.1093/ndt/gfm022.
69. Obi Y., Streja E., Rhee C.M. et al. Incremental hemodialysis, residual kidney function, and mortality risk in incident dialysis patients: A Cohort Study. Am J Kidney Dis 2016; 68: 256-265. doi: 10.1053/j.ajkd.2016.01.008.
70. Ramirez S.P., Kapke A., Port F.K. et al. Dialysis dose scaled to body surface area and size-adjusted, sex-specific patient mortality. Clin J Am Soc Nephrol 2012; 7: 1977-1987. doi: 10.2215/CJN.00390112.
71. Rayner H.C., Zepel L., Fuller D.S. et al. Recovery time, quality of life, and mortality in hemodialysis patients: the Dialysis Outcomes and Practice Patterns Study (DOPPS). Am J Kidney Dis 2014; 64:86-94. doi: 10.1053/j.ajkd.2014.01.014.
72. Foley R.N., Gilbertson D.T., Murray T. et al. Long interdialytic interval and mortality among patients receiving hemodialysis. N Engl J Med 2011; 365: 1099-1107. doi: 10.1056/NEJMoa1103313.
73. Georgianos P.I., Sarafidis P.A., Sinha A.D. et al. Adverse effects of conventional thrice-weekly hemodialysis: is it time to avoid 3-day interdialytic intervals? Am J Nephrol 2015; 41: 400-408. doi: 10.1159/000435842.
74. Chertow G.M., Levin N.W., Beck G.J. et al. In-center hemodialysis six times per week versus three times per week. N Engl J Med 2010; 363: 2287-2300. doi: 10.1056/NEJMoa1001593.
75. Ok E., Duman S., Asci G et al. Comparison of 4-and 8-h dialysis sessions in thrice-weekly in-centre haemodialysis: aprospective, case-controlled study. Nephrol Dial Transplant 2011; 26: 1287-1296. doi: 10.1093/ndt/gfq724.
76. Kotanko P., Garg A.X., Depner T. et al. Effects of frequent hemodialysis on blood pressure: Results from the randomized frequent hemodialysis network trials. Hemodial Int 2015; 19: 386-401. doi: 10.1111/hdi.12255.
77. Rocco M.V., Daugirdas J.T., Greene T. et al. Long-term effects of frequent nocturnal hemodialysis on mortality: The Frequent Hemodialysis Network (FHN) Nocturnal Trial. Am J Kidney Dis 2015; 66: 459-468. doi: 10.1053/j.ajkd.2015.02.331.
78. Chertow G.M., Levin N.W., Beck G.J. et al. Long-term effects of frequent in center hemodialysis. J Am Soc Nephrol 2016; 27: 1830-1836. doi: 10.1681/ASN.2015040426.
79. Kotanko P., Garg A.X., Depner T. et al. Effects of frequent hemodialysis on blood pressure: results from the randomized frequent hemodialysis network trials. Hemodial Int. 2015; 19: 386-401. doi: 10.1111/hdi.12255.
80. Daugirdas J.T., Greene T., Rocco M.V. et al. Effect of frequent hemodialysis on residual kidney function. Kidney Int 2013; 83: 949-958. doi: 10.1038/ki.2012.457.
81. Flythe J.E., Kimmel S.E., Brunelli S.M. Rapid fluid removal during dialysis is associated with cardiovascular morbidity and mortality. Kidney Int. 2011; 79: 250-257. doi: 10.1038/ki.2010.383.
82. Burton J.O., Jefferies H.J., Selby N.M., McIntyre C.W. Hemodialysis-induced repetitive myocardial injury results in global and segmental reduction in systolic cardiac function. Clin J Am Soc Nephrol. 2009; 4: 1925-1931. doi: 10.2215/CJN.04470709.
83. Burton J.O., Jefferies H.J., Selby N.M., McIntyre C.W. Hemodialysis-induced cardiac injury: determinants and associated outcomes. Clin J Am Soc Nephrol. 2009; 4: 914-920. doi: 10.2215/CJN.03900808.
84. McIntyre C.W., Burton J.O., Selby N.M. et al. Hemodialysis-induced cardiac dysfunction is associated with an acute reduction in global and segmental myocardial blood flow. Clin J Am Soc Nephrol. 2008; 3: 19-26. doi: 10.2215/CJN.03170707.
85. MacEwen C., Sutherland S., Daly J. et al. Relationship between hypotension and cerebral ischemia during hemodialysis. J Am Soc Nephrol. 2017; 28: 2511-2520. doi: 10.1681/ASN.2016060704.
86. Assimon M.M., Flythe J.E. Intradialytic blood pressure abnormalities: the highs, the lows and all that lies between. Am J Nephrol. 2015; 42: 337-350. doi: 10.1159/000441982.
87. Seong E.Y., Zheng Y., Winkelmayer W.C. et al. The relationship between intradialytic hypotension and hospitalized mesenteric ischemia: a case-control study. Clin J Am Soc Nephrol. 2018; 13: 1517-1525. doi: 10.2215/CJN.13891217.
88. Assimon M.M., Wenger J.B., Wang L., Flythe J.E. Ultrafiltration rate and mortality in maintenance hemodialysis patients. Am J Kidney Dis. 2016; 68: 911-922.
89. Cybulsky A.V., Matni A., Hollomby D.J. Effects of high sodium dialysate during maintenance hemodialysis. Nephron 1985; 41: 57-61. doi: 10.1159/000183547.
90. Ogden D.A. A double blind crossover comparison of high and low sodium dialysis. Proc Clin Dial Transplant Forum 1978; 8: 157-165.
91. Santos S.F., Peixoto A.J. Revisiting the dialysate sodium prescription as a tool for better blood pressure and interdialytic weight gain management in hemodialysis patients. Clin J Am Soc Nephrol 2008; 3: 522-530. doi: 10.2215/CJN.03360807.
92. Weiner D.E., Brunelli S.M., Hunt A. et al. Improving clinical outcomes among hemodialysis patients: a proposal for a “volume first” approach from the chief medical officers of US dialysis providers. Am J Kidney Dis 2014; 64: 685-695. doi: 10.1053/j.ajkd.2014.07.003.
93. Munoz Mendoza J., Sun S., Chertow G.M. et al. Dialysate sodium and sodium gradient in maintenance hemodialysis: a neglected sodium restriction approach? Nephrol Dial Transplant 2011; 26: 1281-1287. doi: 10.1093/ndt/gfq807.
94. de Paula F.M., Peixoto A.J., Pinto L.V. et al. Clinical consequences of an individualized dialysate sodium prescription in hemodialysis patients. Kidney Int 2004; 66: 1232-1238. doi: 10.1111/j.1523-1755.2004.00876.x.
95. Hecking M., Karaboyas A., Rayner H. et al. Dialysate sodium prescription and blood pressure in hemodialysis patients. Am J Hypertens. 2014; 27: 1160-1169. doi: 10.1093/ajh/hpu040.
96. Kalantar-Zadeh K., Regidor D.L., Kovesdy C.P. Fluid retention is associated with cardiovascular mortality in patients undergoing long-term hemodialysis. Circulation. 2009; 119: 671-679. doi: 10.1161/CIRCULATIONAHA.108.807362.
97. Flythe J.E., Curhan G.C., Brunelli S.M. Disentangling the ultrafiltration rate-mortality association: the respective roles of session length and weight gain. Clin J Am Soc Nephrol. 2013; 8: 1151-1161. doi: 10.2215/CJN.09460912.
98. Colson A., Brinkley A., Braconnier P. et al. Impact of salt reduction in meals consumed during hemodialysis sessions on interdialytic weight gain and hemodynamic stability. Hemodial Int. 2018; 22: 501-506. doi: 10.1111/hdi.12655.
99. Kayikcioglu M., Tumuklu M., Ozkahya M. et al. The benefit of salt restriction in the treatment of end-stage renal disease by haemodialysis. Nephrol Dial Transplant 2009; 24:956-962. doi: 10.1093/ndt/gfn599.
100. Mc Causland F.R., Waikar S.S., Brunelli S.M. Increased dietary sodium is independently associated with greater mortality among prevalent hemodialysis patients. Kidney Int 2012; 82: 204-211. doi: 10.1038/ki.2012.42.
101. Maduell F., Navarro V. Dietary salt intake and blood pressure control in haemodialysis patients. Nephrol Dial Transplant 2000; 15: 2063. doi: 10.1093/ndt/15.12.2063.
102. Lambert K., Mullan J., Mansfield K. An integrative review of the methodology and findings regarding dietary adherence in end stage kidney disease. BMC Nephrol. 2017; 18:318. doi: 10.1186/s12882-017-0734-z.
103. Sevick M.A., Piraino B.M., St-Jules D. et al. No difference in average interdialytic weight gain observed in a randomized trial with a technology-supported behavioral intervention to reduce dietary sodium intake in adults undergoing maintenance hemodialysis in the united states: primary outcomes of the balancewise study. J Ren Nutr. 2016; 26: 149-158.
104. Hu L, St-Jules D.E., Popp C.J., Sevick M.A. Determinants and the role of self-efficacy in a sodium-reduction trial in hemodialysis patients. J Ren Nutr. 2018; 29:3 28-332. doi: 10.1053/j.jrn.2018.10.006.
105. Agarwal R., Sinha A.D., Pappas M.K. et al. Hypertension in hemodialysis patients treated with atenolol or lisinopril: a randomized controlled trial. Nephrol Dial Transplant 2014; 29: 672-681. doi: 10.1093/ndt/gft515.
106. Zannad F., Kessler M., Lehert P. et al. Prevention of cardiovascular events in end-stage renal disease: results of a randomized trial of fosinopril and implications for future studies. Kidney Int 2006; 70: 1318-1324. doi: 10.1038/sj.ki.5001657.
107. Takahashi A., Takase H., Toriyama T. et al. Candesartan, an angiotensin II type-1 receptor blocker, reduces cardiovascular events in patients on chronic haemodialysis-a randomized study. Nephrol Dial Transplant 2006; 21: 2507-2512. doi: 10.1093/ndt/gfl293.
108. Suzuki H., Kanno Y., Sugahara S. et al. Effect of angiotensin receptor blockers on cardiovascular events in patients undergoing hemodialysis: an open-label randomized controlled trial. Am J Kidney Dis 2008; 52: 501-506. doi: 10.1053/j.ajkd.2008.04.031.
109. Iseki K., Arima H., Kohagura K. et al. Effects of angiotensin receptor blockade (ARB) on mortality and cardiovascular outcomes in patients with long-term haemodialysis: a randomized controlled trial. Nephrol Dial Transplant 2013; 28: 1579-1589. doi: 10.1093/ndt/gfs590.
110. Tepel M., Hopfenmueller W., Scholze A. et al. Effect of amlodipine on cardiovascular events in hypertensive haemodialysis patients. Nephrol Dial Transplant2008; 23: 3605-3612. doi: 10.1093/ndt/gfn304.
111. Matsumoto Y., Mori Y., Kageyama S. et al. Spironolactone reduces cardiovascular and cerebrovascular morbidity and mortality in hemodialysis patients. J Am Coll Cardiol 2014; 63: 528-536. doi: 10.1016/j.jacc.2013.09.056.
112. Lin C., Zhang Q., Zhang H. et al. Long-term effects of low-dose spironolactone on chronic dialysis patients: a randomized placebo-controlled study. J Clin Hypertens 2015; 18: 121-128. doi: 10.1111/jch.12628.
113. Agarwal R., Sinha A.D. Cardiovascular protection with antihypertensive drugs in dialysis patients: systematic review and meta-analysis. Hypertension 2009; 53: 860-866. doi: 10.1161/HYPERTENSIONAHA.108.128116.
114. Heerspink H.J., Ninomiya T., Zoungas S. et al. Effect of lowering blood pressure on cardiovascular events and mortality in patients on dialysis: a systematic review and meta-analysis of randomised controlled trials. Lancet 2009; 373: 1009-1015. doi: 10.1016/S0140-6736(09)60212-9.
115. Denker M.G., Cohen D.L. Antihypertensive medications in end-stage renal disease. Semin Dial 2015; 28: 330-336. doi: 10.1111/sdi.12369.
116. Inrig J.K. Antihypertensive agents in hemodialysis patients: a current perspective. Semin Dial 2010; 23: 290-297. doi: 10.1111/j.1525-139X.2009.00697.x.
117. Agarwal R., Flynn J., Pogue V. et al. Assessment and management of hypertension in patients on dialysis. J Am Soc Nephrol. 2014; 25: 1630-1646. doi: 10.1681/ASN.2013060601.
118. Lemes H.P., Araujo S., Nascimento D. et al. Use of small doses of furosemide in chronic kidney disease patients with residual renal function undergoing hemodialysis. Clin Exp Nephrol 2011;15:554-559. doi: 10.1007/s10157-011-0427-z.
119. van Olden R.W., van Meyel J.J., Gerlag P.G. Sensitivity of residual nephrons to high dose furosemide described by diuretic efficiency. Eur J Clin Pharmacol 1995; 47: 483-488. doi: 10.1007/bf00193698
120. Muntner P., Anderson A., Charleston J. et al. Hypertension awareness, treatment, and control in adults with CKD: results from the Chronic Renal Insufficiency Cohort (CRIC) Study. Am J Kidney Dis 2010; 55(3):441-451. doi: 10.1053/j.ajkd.2009.09.014.
121. Bragg-Gresham J.L., Fissell R.B., Mason N.A. et al. Diuretic use, residual renal function, and mortality among hemodialysis patients in the Dialysis Outcomes and Practice Pattern Study (DOPPS). Am J Kidney Dis. 2007; 49: 426-431. doi: 10.1053/j.ajkd.2006.12.012.
122. Sibbel S., Walker A.G., Colson C. et al. Association of continuation of loop diuretics at hemodialysis initiation with clinical outcomes. Clin J Am Soc Nephrol. 2018; 14(1): 95-102. doi: 10.2215/CJN.05080418.
123. Zoccali C., Mallamaci F., Parlongo S. et al. Plasma norepinephrine predicts survival and incident cardiovascular events in patients with end-stage renal disease. Circulation 2002; 105: 1354-1359. doi: 10.1161/hc1102.105261.
124. Jadoul M., Thumma J., Fuller D.S. et al. Modifiable practices associated with sudden death among hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study. Clin J Am Soc Nephrol 2012; 7: 765-774. doi: 10.2215/CJN.08850811.
125. Cice G., Ferrara L., D’Andrea A. et al. Carvedilol increases two-year survivalin dialysis patients with dilated cardiomyopathy: a prospective, placebo controlled trial. J Am Coll Cardiol 2003; 41: 1438-1444. doi: 10.1016/s0735-1097(03)00241-9.
126. Inrig J.K., Van B.P., Kim C. et al. Probing the mechanisms of intradialytic hypertension: a pilot study targeting endothelial cell dysfunction. Clin J Am Soc Nephrol 2012; 7: 1300-1309. doi: 10.2215/CJN.10010911.
127. Levin N.W., Kotanko P., Eckardt K.U. et al. Blood pressure in chronic kidney disease stage 5D-report from a Kidney Disease: Improving Global Outcomes controversies conference. Kidney Int 2010; 77:273-284. doi: 10.1038/ki.2009.469.
128. Weir M.A., Dixon S.N., Fleet J.L. et al. beta-Blocker dialyzability and mortality in older patients receiving hemodialysis. J Am Soc Nephrol 2015; 26: 987-996. doi: 10.1681/ASN.2014040324.
129. Roberts M.A., Pilmore H.L., Ierino F.L. et al. The beta-Blocker to Lower Cardiovascular Dialysis Events (BLOCADE) Feasibility Study: A Randomized Controlled Trial. Am J Kidney Dis 2016; 67: 902-911. doi: 10.1053/j.ajkd.2015.10.029.
130. Kramer H.J., Townsend R.R., Griffin K. et al. KDOQI US Commentary on the 2017 ACC/AHA Hypertension Guideline. Am J Kidney Dis. 2019;73(4):437-458. doi:10.1053/j.ajkd.2019.01.007.
131. Zoccali C., Mallamaci F. Pleiotropic effects of angiotensin II blockers in hemodialysis patients: myth or reality? Kidney Int 2014; 86: 469-471. doi: 10.1038/ki.2014.155.
132. Redon J., Martinez F., Cheung A.K. Special considerations for antihypertensive agents in dialysis patients. Blood Purif 2010; 29: 93-98. doi: 10.1159/000245631.
133. London G.M., Marchais S.J., Guerin A.P. et al. Salt and water retention and calcium blockade in uremia. Circulation 1990; 82: 105-113. doi: 10.1161/01.cir.82.1.105.
134. Aslam S., Santha T., Leone A. et al. Effects of amlodipine and valsartan on oxidative stress and plasma methylarginines in end-stage renal disease patients on hemodialysis. Kidney Int 2006; 70: 2109-2115. doi: 10.1038/sj.ki.5001983.
135. Pitt B., Rossignol P. Mineralocorticoid receptor antagonists in patients with end-stage renal disease on chronic hemodialysis. J Am Coll Cardiol 2014; 63:537-538. doi: 10.1016/j.jacc.2013.09.057.
136. Walsh M., Manns B., Garg A.X. et al. Thesafety of eplerenonein hemodialysis patients: a noninferiority randomized controlled trial. Clin J Am Soc Nephrol 2015;10:1602-1608. doi: 10.221.
137. Charytan D. M., Himmelfarb J., Ikizler T. A. et al. Safety and cardiovascular efficacy of spironolactone in dialysis-dependent ESRD (SPin-D): a randomized, placebo-controlled, multiple dosage trial. Kidney Int. 2019 Apr; 95(4):973-982. doi:10.1016/j.kint.2018.08.034.
138. Rossignol P., Frimat L., Zannad, F. The safety of mineralocorticoid antagonists in maintenance hemodialysis patients: two steps forward. Kidney Int, 2019; 95(4): 747-749. doi:10.1016/j.kint.2018.12.006.

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