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Physiological Mechanisms of Hypertension and Cardiovascular Disease in End-Stage Kidney Disease

  • Mechanisms of Hypertension and Target-Organ Damage (JE Hall and ME Hall, Section Editors)
  • Published:
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Abstract

Purpose of Review

In this article, we summarize recent advances in understanding hypertension and cardiovascular disease in patients with end-stage kidney disease.

Recent Findings

Factors such as anemia, valvular and vascular calcification, vasoconstrictors, uremic toxins, hypoglycemia, carbamylated proteins, oxidative stress, and inflammation have all been associated with the progression of cardiovascular disease in end-stage kidney disease but the causality of these mechanisms has not been proven.

Summary

The high risk of cardiovascular mortality has not improved as in the general population despite many advancements in cardiovascular care over the last two decades. Mechanisms that increase hypertension risk in these patients are centered on the control of extracellular fluid volume; however, over-correction of volume with dialysis can increase risks of intradialytic hypotension and death in these patients. This review presents both recent and classic work that increases our understanding of hypertension and cardiovascular disease in end-stage kidney disease.

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Funding

This work was supported by grants from the National Institute on Minority Health and Health Disparities (R00 MD014738) to JSC.

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  1. Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA

    John S. Clemmer & Tariq Shafi

  2. Division of Nephrology, University of Mississippi Medical Center, 2500 North State Street, Suite L-504, Jackson, MS, 39216, USA

    Tariq Shafi & Yoshitsugu Obi

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Clemmer, J.S., Shafi, T. & Obi, Y. Physiological Mechanisms of Hypertension and Cardiovascular Disease in End-Stage Kidney Disease. Curr Hypertens Rep 24, 413–424 (2022). https://doi.org/10.1007/s11906-022-01203-7

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