Controversy on optimal blood pressure on haemodialysis: normotensive blood pressure values are essential for survival

Abstract

Gérard London, our close friend and a distinguished investigator, argues that blood pressure (BP) values somewhat above the normal range are optimal for survival of patients on maintenance haemodialysis. We strongly disagree on this point and provide arguments that, despite the opinion of prominent investigators in this field, available evidence is in favour of the idea that BP values in the normotensive range are optimal for survival. We acknowledge, however, that definite controlled evidence is not yet available. In the absence of such evidence, clinicians must rely on a very powerful, although very rarely used instrument, i.e. clinical common sense.