Key result
Home and ambulatory BP monitoring outperform routine dialysis-unit readings for hypertension diagnosis and mortality prognostication.
Why the study?
The contribution of increased blood pressure to cardiovascular morbidity and mortality in dialysis patients remains debated, largely due to difficulties in accurately diagnosing hypertension.
Do home and ambulatory blood pressure monitoring improve the diagnosis of hypertension and prognostication of mortality compared to routine peridialytic recordings in dialysis patients?
Do home and ambulatory blood pressure monitoring improve the diagnosis of hypertension and prognostication of mortality compared to routine peridialytic recordings in dialysis patients?
Home and ambulatory blood pressure monitoring provide more accurate diagnostic and prognostic information than routine dialysis-unit measurements in patients with end-stage kidney disease.
Supports preferring out-of-office BP monitoring in dialysis; leaves open whether adoption improves outcomes in RCTs.
Whereas hypertension is an established cardiovascular risk factor in the general population, the contribution of increased blood pressure (BP) to the huge burden of cardiovascular morbidity and mortality in patients receiving dialysis continues to be debated. In a large part, this controversy is attributable to particular difficulties in the accurate diagnosis of hypertension. The reverse epidemiology of hypertension in dialysis patients is based on evidence from large cohort studies showing that routine predialysis or postdialysis BP measurements exhibit a U-shaped or J-shaped association with cardiovascular or all-cause mortality. However, substantial evidence supports the notion that home or ambulatory BP measurements are superior to dialysis-unit BP recordings in diagnosing hypertension, in detecting evidence of target-organ damage and in prognosticating the all-cause death risk. In the first part of this article, we explore the accuracy of different methods of BP measurement in diagnosing hypertension among patients on dialysis. In the second part, we describe how the epidemiology of hypertension is modified when the assessment of BP is based on dialysis-unit versus home or ambulatory recordings.
No takes yet. Share an insight, caveat, or question.
Georgianos et al. (2022) conducted a review in End-stage kidney disease on dialysis. Home or ambulatory blood pressure monitoring vs. Routine peridialytic blood pressure recordings was evaluated on Diagnostic accuracy and mortality prognostication. Home and ambulatory blood pressure measurements are superior to routine dialysis-unit recordings for diagnosing hypertension and prognosticating all-cause mortality in dialysis patients.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: