The association of home blood pressure with all-cause mortality in hemodialysis patients: A prospective observational study.
Ther Apher Dial
; 28(5): 697-705, 2024 Oct.
Article
in En
| MEDLINE
| ID: mdl-38742273
ABSTRACT
INTRODUCTION:
Prior observational studies conducted in the hemodialysis population have suggested a reverse association between dialysis-unit blood pressure (BP) and mortality. The present study aimed to investigate the prognostic association of home versus dialysis-unit BP with all-cause mortality in hemodialysis patients.METHODS:
At baseline, 146 patients receiving maintenance hemodialysis underwent assessment of their BP with the followingmethods:
(i) 2-week averaged routine predialysis and postdialysis BP measurements; (ii) home BP monitoring for 1 week that included duplicate morning and evening BP measurements with the use of validated devices.RESULTS:
Over a median follow-up period of 38 months (interquartile range [IQR] 22-54), 44 patients (31.1%) died. In Kaplan-Meier curves, predialysis and postdialysis systolic BP (SBP) was not associated with all-cause mortality, while home SBP appeared to be of prognostic significance (log rank p = 0.029). After stratifying patients into quartiles, all-cause mortality was lowest when home SBP was ranging from 128.1 to 136.8 mmHg (quartile 2). In univariate Cox regression analysis, using quartile 2 as a referent category, the risk of all-cause mortality was 3.32-fold higher in quartile 1, 1.53-fold higher in quartile 3 and 3.25-fold higher in quartile 4. The risk-association remained unchanged after adjustment for several confounding factors (adjusted hazard ratio 4.79, 1.79, 3.63 for quartiles 1, 3, and 4 of home systolic BP, respectively).CONCLUSION:
Our findings suggest that among hemodialysis patients, 1-week averaged home SBP is independently associated with all-cause mortality. In sharp contrast, SBP recorded either before or after dialysis over 2 weeks is not prognostically informative.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Blood Pressure
/
Renal Dialysis
/
Blood Pressure Monitoring, Ambulatory
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Ther Apher Dial
/
Therapeutic apheresis and dialysis
Journal subject:
HEMATOLOGIA
Year:
2024
Type:
Article
Affiliation country:
Greece