Details

Autor(en) / Beteiligte

• Wang, Ying
• Qin, Yan
• Fan, Xiaohong
• Cai, Jianfang
• Ye, Wei
• Xia, Jinghua
• Li, Mingxi
• Li, Xuemei
• Li, Xuewang
• Chen, Limeng

Titel

Variability in Predialysis Systolic Blood Pressure and Long-Term Outcomes in Hemodialysis Patients

Ist Teil von

• Kidney & blood pressure research, 2018-01, Vol.43 (1), p.115-124

Ort / Verlag

Basel, Switzerland: S. Karger AG

Erscheinungsjahr

2018

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• Background/Aims: While systolic blood pressure variability (SBPV) is an independent risk factor for mortality in the general population, its association with outcomes in hemodialysis patients has been less well-investigated. Methods: In this retrospective study, we enrolled 99 eligible HD patients from 2006 to 2016. Predialysis blood pressure measurements obtained over 1-year period were used to determine each patient’s BPV. The standard deviation (SD), the coefficient of variation (CV) and the variation independent of the mean (VIM) were used as metrics of BPV. Results: During a median follow-up period of 68 months, 52 patients died, and cardiovascular disease (31.3%) was the primary cause of death in these patients. After adjusting for covariates, the hazard ratios (HRs) for all-cause and cardiovascular mortality were 1.80 (95% confidence interval (CI) 1.11-2.92) and 1.71 (95% CI 1.01-2.90), respectively, for a one percent increase in CV. Variability in the volume removed per session and predialysis serum albumin and calcium levels were identified as factors associated with BPV. Conclusion: In this study, we demonstrate that greater variability in predialysis SBP is associated with long-term mortality in hemodialysis patients. Controlling volume variation, avoiding hypoalbuminemia and reducing blood calcium levels might reduce SBP variability and thereby improve prognoses in these patients.