It’s fluid

Hemodialysis patients are more prone to high blood pressure, warns Dr Neeru P Aggarwal

Blood pressure is a measurement of the force of blood against your artery walls. A person’s blood pressure is measured using two numbers, the systolic, in which the heart pumps blood around the body and the other one is diastolic when your heart is at rest. In normal conditions, a person’s blood pressure should be 130/80 mmHg.

However, people on dialysis are more prone to high blood pressure which is also known as hypertension. Many patients who are on end-stage renal disease are maintained on hemodialysis and are at a greater risk of hypertension due to impaired baroreflex function. Blood pressure and chronic hypertension contributes significantly to the high incidence of cardiovascular disease and the markedly reduced lifespan of hemodialysis patients.

What one needs to understand is the cause of high blood pressure. Fluid balance and blood pressure go together. When there is an excess amount of fluid in your body, water is pushed from your blood system into your surrounding tissues.

This is observed more in patients with chronic kidney disease and more in dialysis patients who pass a reduced amount of urine. Excess fluid can cause high blood pressure as well as swelling in the ankles and legs. Sometimes it can reach up to the lungs in which case the patient might experience difficulty in breathing.

Most people on dialysis will need blood pressure medicines to ensure their blood pressure remains under control, and this is generally taken on the days when a patient is not going for dialysis.

Since blood pressure medicines work in different ways and sometimes the same medicines cannot be used forever, one should consult their doctor to ensure they are consuming the right medication.

As we are aware that blood pressure is caused by too much fluid in the body, reducing the dry weight can help a patient on dialysis to manage his blood pressure well. In certain cases, some patients might even have to stop blood pressure medication and have normal blood pressure when they reach their true dry weight. There are many more ways how one can improve their blood pressure if it is too high:

Stick to your fluid allowance, i.e., how much fluid you can drink in 24 hours.

Reduce the intake of salt in your diet.

Exercise within your capabilities. Any form of physical exercise that a person undertakes is good for his or her overall health and potentially your blood pressure as well.

If you are diabetic, keep your blood glucose under control.

Ensure your medications are taken as prescribed.

(The author is a nephrologist & renal specialist.)