Hypertension in continuous ambulatory peritoneal dialysis patients: what do we know and what can we do about it?

Despite many advantages of CAPD in maintaining hemodynamic stability, approximately 50%-60% of CAPD patients have hypertension and require antihypertensive treatment. ACE inhibitors and beta-blockers are the preferred first-line antihypertensive drugs in these patients, but some patients may require additional long-acting calcium antagonists to enhance antihypertensive effects. Despite antihypertensive treatment, many patients often fail to maintain BP within optimal ranges, and this fact may contribute to the high incidences of cardiovascular morbidity and mortality. Vigilance is clearly desirable by the patient and the physician to maintain BP within target ranges most of the time. Because dialysis patients also have many other cardiovascular risk factors, the strategy to decrease cardiovascular mortality should be a combined effort targeting all potential risk factors at the same time.