Spanner E, Suri R, Heidenheim AP, Lindsay RM. The impact of quotidian hemodialysis on nutrition. Am J Kidney Dis. 2003;42(1 suppl):30-35. Despite the health benefits that home and more frequent hemodialysis may provide to those with chronic kidney disease, these forms of therapy are not for everyone. Please review this information carefully and discuss it with your doctor as you evaluate your therapy options. Frohlich ED. Evaluation and management of the patients with essential hypertension. In: Parmley WW, Chatterjee K, eds. Cardiology. Philadelphia: Lippincott,1989;23:1-15. Over 1.1 billion people worldwide, one-fourth of all men and one-fifth of all women suffer from hypertension and the condition is in control in less than 20% of the affected population. It is also the main risk factor and cause of hypertensive heart disease 1. Associations Classical imaging features of hypertensive heart disease include left ventricular hypertrophy and left atrial enlargement which can be visualized in echocardiography, cardiac CT and cardiac MRI. Plain radiograph

Hypertensive heart disease | Radiology Reference Article Hypertensive heart disease | Radiology Reference Article

Díez J, Querejeta R, López B, González A, Larman M, Martínez Ubago J. Losartan-Dependent Regression of Myocardial Fibrosis Is Associated With Reduction of Left Ventricular Chamber Stiffness in Hypertensive Patients. Circulation. 2002;105(21):2512-7. doi:10.1161/01.cir.0000017264.66561.3d - Pubmed Another part of the management includes lifestyle modifications and the control of other cardiovascular risk factors. Differential diagnosis Angiotensin-converting enzyme (ACE) inhibitors, AT 1 receptor antagonists and diuretics showed good results in the treatment with regression of left ventricular hypertrophy, myocardial fibrosis and an improvement in diastolic dysfunction 3,4,9,10. Concomitant ischemic heart disease, heart failure and atrial fibrillation or arrhythmias should be treated accordingly. If hemodialysis patients currently treating three days per week are experiencing large fluid gains, impaired cardiovascular function, hemodynamic instability, or are otherwise not tolerating their current therapy, they may want to consider more frequent hemodialysis. More frequent home hemodialysis is associated with: Significant Cardiovascular Benefits: Kannel WB. Elevated systolic blood pressure as a cardiovascular risk factor. Am J Cardiol 2000;85:251-5.

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The solo HHD clearance was supported by a patient preference study, which provided the following findings: 24 Sustained hypertension causes structural and functional abnormalities of the heart, involving ventricular and atrial myocardium as well as epicardial and intramural coronary arteries. As a result, three different, although obviously related to each other, cardiac diseases in hypertensive patients may be recognized: heart failure, myocardial ischaemia, and atrial fibrillation9-17. These three main cardiac complications of hypertension can take place separately or combined, at different degrees of severity, or in various evolutive stages18.

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Culleton BF, Walsh M, Klarenbach SW, et al. Effect of frequent nocturnal hemodialysis vs conventional hemodialysis on left ventricular mass and quality of life. JAMA. 2007;298(11):1291–1299. Thomas MC, Dublin S, Kaplan RC, Glazer NL, Lumley T, Longstreth WT, et al. Blood pressure control and risk of incident atrial fibrillation. Am J Hypertens 2008;21:1111-6. Struijker Boudier HA, Cohuet GM, Baumann M, Safar ME. The heart, macrocirculation and microcirculation in hypertension: a unifying hypothesis. J Hypertens Suppl 2003;21(Suppl 3):S19-23.Nordin S, Dancy L, Moon J, Sado D. Clinical Applications of Multiparametric CMR in Left Ventricular Hypertrophy. Int J Cardiovasc Imaging. 2018;34(4):577-85. doi:10.1007/s10554-018-1320-6 - Pubmed