Low Blood Pressure puts Kidney Patients at Risk of Stroke, as well as High Blood Pressure

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It is already known that people with high blood pressure and chronic kidney disease (CKD) face an increased risk of a stroke. Now researchers at Tufts-New England Medical Center reveal that low blood pressure can also be a risk factor for people with CKD.

They looked at data on more than 20,000 US citizens in a study on heart disease risk. In this group, 7.6 percent had CKD and were found to be at increased risk of having a stroke. With or without CKD, high blood pressure increased the risk of stroke. In the CKD patients, systolic blood pressure lower than 120 mm Hg was similarly linked to increased stroke risk compared to those with systolic blood pressures of 120-129 mm Hg.

Previous research has also shown a dip in blood pressure during dialysis can lead to seizures, heart damage, and even death. Patients experiencing this problem are at risk for short-term troubles like gastrointestinal, muscular and neurologic symptoms. The investigators found patients who had the most frequent low blood pressure episodes during dialysis were two-times more likely to have a clotted fistula than those with the fewest episodes. According to the researchers, low blood pressure during dialysis occurs in about 25 percent of dialysis sessions.

Patients who experience a sudden drop in blood pressure while undergoing dialysis are at an increased risk of blood

clotting at the point where the blood vessels are connected to the dialysis machine, which is known as vascular access. Clotting is a major complication of an access point. It can lead to its closure. These access points do not last forever. Many patients go through multiple access points moving from the left to right arm, or into the legs if necessary after repeated failures in the arms. When a patient runs out of access points, it becomes an emergency situation. Therefore, anything you can do to extend the life of the access point is important.

Although the impact appeared to be greatest among those receiving drugs to lower their blood pressure, the design of the study does not allow conclusions about any possible danger of lowering blood pressure in this way. Hence, those on blood pressure lowering medication should NOT stop them suddenly, rather they should talk to their doctor first. Similarly, for individuals consistently experiencing low blood pressure, who are not on Blood Pressure Controlling (BPC) medication, should likewise consult with your Nephrologist  about this problem.

References:

"Patients with Kidney Disease and Low Blood Pressure Face Stroke Risk." NewsFixca RSS.

"Low Blood Pressure Dangerous During Dialysis." Ivanhoe Medical Broadcast News.

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CKD Patients Should Track Their Blood Pressure Numbers
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"Some Exercise Is Better Than Others for Lowering Blood Pressure"