Lepăr Zoe 1, Rădulescu Daniela 2, Peride Ileana 2, Niculae A., Checheriţă I. Al. 2, Ciocâlteu Al. 2 *
1 Bucharest Health Insurance House
2 Department of Nephrology and Dialysis, Clinical Department No. 3, “Carol Davila” University of Medicine and Pharmacy, “St. John” Emergency Clinical Hospital, Bucharest
Abstract
Hypovolemia and hypertension are important factors for worsening a previous CKD. The present article highlights the importance of concomitant treatment of both factors in nondialyzed CKD patients with hypertensive crises. Material and methods. The study included 454 patients with chronic kidney disease stage 3 or 4, who were admitted for hypertensive crises and who received treatment in accordance with volemic status and plasma sodium. Results. 96 patients had hypovolemia (21%). Reducing systolic blood pressure ≤ 160mmHg was achieved faster in patients whom hypovolemia was corrected by parenteral route. Patients with hyponatremia received saline solutions via parenteral administration with better clinical benefits than glucose isotonic solutions. Conclusions. Optimal treatment of hypovolemic hypertensive crises requires promptly restoring of plasma volume. In some cases with hyponatremia, infusion of sodium chloride solution will correct, paradoxically, the raise in blood pressure.