Seasonal variation of blood pressure in maintenance hemodialysis

Castro, de; D, Mion Júnior; Marcondes, M; Sabbaga, E

doi:10.1590/s1516-31801998000400006

Cited by 6 publications

(6 citation statements)

References 25 publications

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“…Similar findings for predialysis BP were noted in studies of 16 patients in Brazil (19), 102 patients in Uruguay (20), 53 patients in France (18), 144 patients in Japan (21), and the 1416 patients in this study (Table 1). Plausible mechanisms for the lower BP in the summer include decreased interdialytic fluid gain and thus decreased intravascular volume during that season.…”

Section: Variations In Bpsupporting

confidence: 90%

“…The magnitudes of the reported seasonal changes were as great as 12 mmHg for systolic pressure and 7 mmHg for diastolic pressure in one study (18). Similar to findings for the general population, BP values for the dialysis patients in three of those studies (18,19,21) were inversely correlated with outdoor temperatures, with the highest mean BP occurring in the winter. In addition, BP was positively correlated with outdoor humidity in two studies (18,21).…”

supporting

confidence: 67%

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Seasonal Variations in Clinical and Laboratory Variables among Chronic Hemodialysis Patients

Cheung

Gao

Greene

et al. 2002

Journal of the American Society of Nephrology

105

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Abstract. Seasonal variations in BP among chronic hemodialysis patients have been reported. It was hypothesized that other characteristics of these patients might also vary with the seasons. Twenty-one clinical and laboratory variables were examined for seasonal variations among 1445 patients enrolled in the Hemodialysis Study, sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases. Mixed-effects models were applied to longitudinal changes (up to 45 mo) for individual patients for 19 of the 21 variables, which were measured at least twice each year, to determine the seasonal component of each variable. Seasonal variations in the other two variables, i.e., protein and energy intakes determined from annual dietary records, were assessed in cross-sectional comparisons of intakes of patients entering the study at different time points. Thirteen of the 21 variables examined demonstrated statistically significant (P Ͻ 0.01) seasonal components in their longitudinal variations. Predialysis blood urea nitrogen concentrations peaked in March, which coincided approximately with the peak protein catabolic rates, as well as protein and energy intakes (determined by dietary recall). Predialysis systolic and diastolic BP values were highest in winter and lowest in summer, corroborating previous reports. In addition, the lower predialysis BP values in summer were associated with higher outdoor temperatures and less interdialytic fluid gain. The mean predialysis hematocrit values were highest in July, which could not be attributed solely to the estimated changes in plasma volume. Seasonal variations in clinical and laboratory variables occur commonly among chronic hemodialysis patients. The reasons for most of these variations are not apparent and require further investigation. Nonetheless, failure to consider these variations might lead to biases in the interpretation of clinical studies. In addition, awareness of these variations might facilitate the interpretation of laboratory results and the clinical treatment of these patients.Normal cell physiologic processes (1), body composition (2,3), organ function (4 -8), clinical laboratory test results (9 -14), and disease processes (15-17) have all been demonstrated to be subject to seasonal variations in the general population. In particular, BP undergoes cyclic changes that are inversely correlated with outdoor temperatures, with peak levels in winter and the nadir in summer (2,4 -7). Seasonal variations in predialysis BP were recently observed among chronic hemodialysis patients on three different continents, encompassing both hemispheres, i.e., Europe, South America, and Asia (18 -21). The magnitudes of the reported seasonal changes were as great as 12 mmHg for systolic pressure and 7 mmHg for diastolic pressure in one study (18). Similar to findings for the general population, BP values for the dialysis patients in three of those studies (18,19,21) were inversely correlated with outdoor temperatures, with the highest mean BP occurring in the winter...

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Section: Variations In Bpsupporting

confidence: 90%

supporting

confidence: 67%

Seasonal Variations in Clinical and Laboratory Variables among Chronic Hemodialysis Patients

Cheung

Gao

Greene

et al. 2002

Journal of the American Society of Nephrology

105

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“…Secondly, blood pressure has a seasonal change from highest in winter to lowest in summer. This seasonal variation coincides with that of stroke [30][31][32][33][34][35][36].…”

Section: Discussionsupporting

confidence: 61%

Seasonal changes in mortality rates from main causes of death in Japan

Nakaji

Parodi²,

Fontana³

et al. 2004

Eur J Epidemiol

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“…Higher IDWG and pre-SBP have been observed in winter periods in dialysis patients dwelling in Northern [ 2 , 3 , 5 ] and Southern temperate zones [ 6 ]. To the best of our knowledge only a single study from Brazil addressed seasonal differences in blood pressure in a tropical climate [ 19 ]. This study reported higher diastolic and mean blood pressure in winter, but no difference in IDWG between seasons.…”

Section: Discussionmentioning

confidence: 99%

Seasonal variations in mortality and clinical indicators in international hemodialysis populations from the MONDO registry

Guinsburg¹,

Usvyat

Etter

et al. 2015

BMC Nephrol

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BackgroundSeasonal mortality differences have been reported in US hemodialysis (HD) patients. Here we examine the effect of seasons on mortality, clinical and laboratory parameters on a global scale.MethodsDatabases from the international Monitoring Dialysis Outcomes (MONDO) consortium were queried to identify patients who received in-center HD for at least 1 year. Clinics were stratified by hemisphere and climate zone (tropical or temperate). We recorded mortality and computed averages of pre-dialysis systolic blood pressure (pre-SBP), interdialytic weight gain (IDWG), serum albumin, and log C-reactive protein (CRP). We explored seasonal effects using cosinor analysis and adjusted linear mixed models globally, and after stratification.ResultsData from 87,399 patients were included (northern temperate: 63,671; northern tropical: 7,159; southern temperate: 13,917; southern tropical: 2,652 patients). Globally, mortality was highest in winter. Following stratification, mortality was significantly lower in spring and summer compared to winter in temperate, but not in tropical zones. Globally, pre-SBP and IDWG were lower in summer and spring as compared to winter, although less pronounced in tropical zones. Except for southern temperate zone, serum albumin levels were higher in winter. CRP levels were highest in winter.ConclusionSignificant global seasonal variations in mortality, pre-SBP, IDWG, albumin and CRP were observed. Seasonal variations in mortality were most pronounced in temperate climate zones.Electronic supplementary materialThe online version of this article (doi:10.1186/s12882-015-0129-y) contains supplementary material, which is available to authorized users.

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Seasonal variation of blood pressure in maintenance hemodialysis

Cited by 6 publications

References 25 publications

Seasonal Variations in Clinical and Laboratory Variables among Chronic Hemodialysis Patients

Seasonal Variations in Clinical and Laboratory Variables among Chronic Hemodialysis Patients

Seasonal changes in mortality rates from main causes of death in Japan

Seasonal variations in mortality and clinical indicators in international hemodialysis populations from the MONDO registry

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