Is hypertension a mortality risk factor in dialysis?

We retrospectively studied 370 chronic uremic patients, 234 males and 136 females with a mean age of 53 +/- 15 years, to determine the number of mortalities due to hypertension. With hypertension defined as blood pressure values > 150/90, a total of 168 patients were found to be normotensive and 202 as hypertensive. Blood pressure was also considered in association with some prognostic variables such as the patient's age, time of dialysis, renal diagnosis, and dialytic treatment (hemodialysis or peritoneal dialysis). No significant difference in survival was found between normotensive and hypertensive patients. Patients with diabetic nephopathy had a significantly poorer survival experience with respect to other nephropathies, independently of blood pressure values after beginning dialysis treatment. The Cox proportional hazard analysis showed an increased risk of death from aging and peritoneal dialysis, while the chi 2 test showed the role of hypertension as a mortality risk factor only in patients less than 50 years old (18% of deaths among normotensives vs. 31% of deaths among hypertensives, P < 0.05). We conclude that hypertension does not seem to represent the primary risk factor for overall survival in dialysis therapy.