Nocturnal blood pressure and 24-hour pulse pressure are potent indicators of mortality in hemodialysis patients

Amar, Jacques; Vernier, I; Rossignol, Elisabeth; Bongard, Vanina; Arnaud, Catherine; Conté, J; Salvador, M.; Chamontin, B.

doi:10.1046/j.1523-1755.2000.00107.x

Cited by 216 publications

(185 citation statements)

References 28 publications

Supporting

Mentioning

168

Contrasting

Unclassified

Order By: Relevance

“…The effect of these factors in patients who undergo maintenance HD is likely to intensify over time. Increased arterial stiffness and elevated PP are strong independent predictors of all-cause mortality and mainly cardiovascular mortality among patients with ESRD (27)(28)(29)(30). Taken together, this may explain the correlation between PP and hazard for death in patients with Ͼ10 yr of HD.…”

Section: Discussionmentioning

confidence: 85%

Mortality Predictors after 10 Years of Dialysis

Ajiro

Alchi

Narita

et al. 2007

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Background: This work aimed to examine the predictive value for death of various clinical variables after long-term hemodialysis (HD).Design, setting, participants, and measurements: A total of 947 patients (597 men and 350 women, aged 21 to 93 yr) who were undergoing maintenance HD in Niigata, Japan, were stratified into two cohorts: Those with >10 yr of prior HD at study enrollment (n ‫؍‬ 391) and those with <10 yr of previous therapy (n ‫؍‬ 556). The survival of patients was examined for up to 40 mo (1999 to 2003) with the Cox proportional hazards model. Baseline clinical and dialysis data and serum biochemistries were used as independent variables. For adjustment for bias in patient selection, patient survival in either cohort was analyzed separately.Results: In patients with >10 yr of HD, high pulse pressure, cerebrovascular disease, low serum creatinine, and low Kt/V values were the mortality risk predictors, whereas for those with <10 yr of HD, age and cerebrovascular disease were independent risk predictors for death. Diabetes, coronary artery disease, serum albumin, and C-reactive protein were NS predictors in those with long-term HD.Conclusions: Providing adequate dosage of dialysis and achieving a better control of pulse pressure may further improve survival in selected patients who had undergone HD for >10 yr.

show abstract

Section: Discussionmentioning

confidence: 85%

Mortality Predictors after 10 Years of Dialysis

Ajiro

Alchi

Narita

et al. 2007

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

show abstract

“…It has been reported that ambulatory blood pressure monitoring (ABPM) data in dialysis patients are a better predictor for development of LVH and cardiovascular mortality than casual blood pressure (BP) measurements. 4,5 Casual BP measurements are far from being ideal to reflect BP levels precisely in dialysis patients and adjusting antihypertensive treatment according to casual BP measurements may cause an inadequate BP control. ABPM allows a better assessment in the course of BP levels during the day.…”

Section: Introductionmentioning

confidence: 99%

Ambulatory blood pressure monitoring in haemodialysis and continuous ambulatory peritoneal dialysis (CAPD) patients

et al. 2002

View full text Add to dashboard Cite

The aim of this study was to compare the results of the 44-h ambulatory blood pressure monitoring (ABPM) data between haemodialysis (HDp) and CAPD patients and to investigate the relation of circadian rhythm in blood pressure (BP) with development of left ventricular hypertrophy. Twenty-two HDp (11 male, 11 female, mean age: 50 ± 17 years) and 24 CAPDp (11 male, 13 female, mean age: 47 ± 15 years) were included. Echocardiographic measurements and ABPM were performed in all study groups. ABPM of the first and second days were analysed separately and compared with CAPDp. Left ventricular hypertrophy was detected in 17 of the 22 HDp (77%) and 17 of the 24 CAPDp (71%). There was no significant differences between HD and CAPDp in respect to 44-h, daytime and night-time systolic and diastolic BP values. Although the course of BP in CAPDp was stable during the 44-h period, systolic and diastolic BP levels on the second day were significantly higher than those of on the first day in HDp (P Ͻ 0.001

show abstract

“…Indeed, several studies have reported the relationship between pulse pressure and mortality or cardiovascular events in HD patients (13)(14)(15)(16)(17). In this study, we studied in a prospective cohort whether WAB was a more useful prognostic marker in HD patients than one-point BP measurement and investigated which components of WAB were the most potent marker in evaluating the effect of hypertension on cardiovascular events (CVE) or all-cause mortality in HD patients.…”

mentioning

confidence: 99%

Weekly Averaged Blood Pressure Is More Important than a Single-Point Blood Pressure Measurement in the Risk Stratification of Dialysis Patients

Moriya

Oka

Maesato

et al. 2008

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Background and objectives: With regard to monitoring blood pressure in hemodialysis patients, it is important to define clearly the time point at which the blood pressure is measured, because the blood pressure of hemodialysis patients varies with each hemodialysis session as a result of loss of excess fluid.Design, setting, participants, & measurements: Using weekly averaged blood pressure, 96 hemodialysis patients were studied prospectively for 35 mo. All patients were followed up for cardiovascular events or death from all causes.Results: Pulse weekly averaged blood pressure and age at enrollment were significantly higher and parathyroid hormone level was significantly lower in patients with cardiovascular events compared with those without cardiovascular events; however, none of the components of pre-or postdialysis blood pressure was significantly different between patients with and without cardiovascular events. Pulse weekly averaged blood pressure, prepulse pressure, age, and human atrial natriuretic peptide were significantly higher in patients who died than in survivors. Kaplan-Meier method with a log-rank test demonstrated that survival free rate from cardiovascular events and that of all-cause mortality in patients with pulse weekly averaged blood pressure >70 mmHg were significantly lower than those in the remaining patients.Conclusions: One-point measurement of blood pressure is insufficient to evaluate hypertension and prognosis of hemodialysis patients, and weekly averaged blood pressure is a useful marker because of averaging fluctuations of blood pressure during 1 wk. Among components of weekly averaged blood pressure, pulse weekly averaged blood pressure could be a good prognostic marker of the incidence of both cardiovascular events and all-cause mortality in hemodialysis patients.

show abstract

Nocturnal blood pressure and 24-hour pulse pressure are potent indicators of mortality in hemodialysis patients

Cited by 216 publications

References 28 publications

Mortality Predictors after 10 Years of Dialysis

Mortality Predictors after 10 Years of Dialysis

Ambulatory blood pressure monitoring in haemodialysis and continuous ambulatory peritoneal dialysis (CAPD) patients

Weekly Averaged Blood Pressure Is More Important than a Single-Point Blood Pressure Measurement in the Risk Stratification of Dialysis Patients

Contact Info

Product

Resources

About