Key result
Mean pre-intra-post-hemodialysis and pre-post-hemodialysis systolic blood pressures accurately predicted 2-week home systolic blood pressure with areas under the curve of 0.812 and 0.801, respectively.
Why the study?
Which dialysis unit blood pressure measurement is most accurate for predicting home blood pressure in patients undergoing hemodialysis?
Cross-Sectional (n=35)
No
Which dialysis unit blood pressure measurement is most accurate for predicting home blood pressure in patients undergoing hemodialysis?
Effect estimate: AUC 0.812 (95% CI 0.651-0.964)
Averaged pre-intra-post-hemodialysis and pre-post-hemodialysis systolic blood pressures have similar accuracy and are useful for predicting home systolic blood pressure in hemodialysis patients when ambulatory or home monitoring is unavailable.
May aid home SBP estimation from averaged dialysis BP when monitoring unavailable; hypothesis-generating, requiring prospective validation.
BACKGROUND/AIMS: We investigated which dialysis unit blood pressure (BP) is the most useful for predicting home BP in patients undergoing hemodialysis (HD). METHODS: Patients undergoing HD who had been treated > 3 months were included in this study. Exclusion criteria were hospitalized patients with acute illness and changes in dry weight and anti-hypertensive drugs 2 weeks before the study. We used the dialysis unit BP recording data, such as pre-HD, intra-HD, post-HD, mean pre-HD, and post-HD (pre-post-HD), mean pre-HD, intra-HD, and post-HD (pre-intra-post-HD) BP. Home BP (the same period of dialysis unit BP) was monitored as a reference method during 2 weeks using the same automatic oscillometric device. Patients were asked to record their BP three times daily (wake up, between noon and 6:00 PM, and at bedtime). RESULTS: = 0.307, respectively). Areas under the receiver operating characteristic curve for pre-intra-post-HD and prepost-HD SBP with 2-week home BP as the reference standard were 0.812 and 0.801, respectively. CONCLUSIONS: These results suggest that pre-intra-post-HD and pre-post-HD SBP had similar accuracy for predicting mean 2-week home SBP in HD patients. Therefore, pre-intra-post-HD and pre-post-HD SBP should be useful for predicting home SBP in HD patients if ambulatory or home BP measurements are unavailable.
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Yoon et al. (2016) conducted a cross-sectional in End-stage renal disease undergoing hemodialysis (n=35). Dialysis unit blood pressure measurements (pre-intra-post-HD SBP) vs. 2-week home blood pressure (HBP) was evaluated on Area under the ROC curve for pre-intra-post-HD SBP predicting 2-week home SBP (AUC 0.812, 95% CI 0.651-0.964). Mean pre-intra-post-hemodialysis and pre-post-hemodialysis systolic blood pressures accurately predicted 2-week home systolic blood pressure with areas under the curve of 0.812 and 0.801, respectively.
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