{"id":"4ea23a470715","type":"article","url":"https://hartvaat.nl/2026/01/28/hypertensie-bij-dialysepatienten-de-kloof-tussen-bewijs-en-praktijk/","title":"Hypertensie bij dialysepatiënten: de kloof tussen bewijs en praktijk","title_en":"Hypertension in Patients With End-Stage Kidney Disease Requiring Dialysis: Bridging the Divide Between Evidence and Practice","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog","huisarts","internist"],"tags":["acuut-hartfalen","ambulante-bloeddrukmeting","anemie-ckd","bloeddrukbehandeling","chronische-nierziekte","renale-denervatie","vrouwen"],"journal":"Hypertension","doi":"https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.24344","source_url":"https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.24344","authors":["Laura Mayeda"],"significance":6,"published":"2026-01-28","source_date":"2026-01-28","image":"","kennis":["https://hartvaat.nl/kennis/nierziekte/raas-blokkade-bij-nierziekte/","https://hartvaat.nl/kennis/nierziekte/nsaids-en-nierziekte/"],"congress":"","summary_en":"This review addressed hypertension management in dialysis patients, highlighting the distinct pathophysiology (volume overload, sympathetic activation, arterial stiffness) and evidence gaps that make blood pressure control challenging in end-stage kidney disease.","created":"2026-07-03T10:25:30Z","updated":"2026-07-03T18:38:16Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Hypertensie treft meer dan 80% van de dialysepatiënten en de pathofysiologie verschilt van die bij de algemene bevolking. Dit overzicht bespreekt de complexe behandeluitdagingen en de kloof tussen beschikbaar bewijs en klinische praktijk.","abstract_original":"Hypertension, Volume 83, Issue 3, Page e24344, March 1, 2026. Hypertension is a highly prevalent and modifiable risk factor, affecting >80% of patients undergoing dialysis. Its pathophysiology is complex and differs from that of the general population, driven by factors such as volume overload, arterial stiffness, overactivation of the sympathetic and renin-angiotensin-aldosterone systems, and endothelial dysfunction. Achieving optimal blood pressure and volume control is central to dialysis care, with significant implications for cardiovascular outcomes and patient quality of life. Despite its importance, evidence guiding hypertension management in this population remains limited. Furthermore, reliable, objective methods to assess extracellular volume are lacking. This review examines current approaches to the assessment and management of hypertension in maintenance hemodialysis, summarizing existing evidence, clinical guidelines, and ongoing challenges in blood pressure and vo"}