Resistant Hypertension in a Dialysis Patient

Originally published 29 Jun 2020 | Hypertension

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Case Introduction

We present a case of resistant hypertension in a patient with chronic kidney disease (CKD). The patient is a 41-year-old woman who first presented to her general practitioner almost 20 years ago with peripheral edema and lethargy. She is a lifelong smoker and is obese. Her medical history includes asthma and cervical spondylosis. The reason for referral to the renal team was dipstick-positive proteinuria in the context of low serum albumin.

As this case is from Scotland, the majority of results will be reported in SI units. In the context of a 24-hour urinary protein excretion of almost 4 g per 24 hours, hypoalbuminemia of 25 g/L, and clinical evidence of peripheral edema bilaterally to her knees, a diagnosis of nephrotic syndrome was made. The patient’s renal function and blood pressure (BP) were normal at this stage.

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