Why the study?
Do patients with ESRD secondary to AH and/or DM have different peripheral and central ambulatory blood pressure profiles compared to those with primary kidney disease?
Observational (n=68)
Do patients with ESRD secondary to AH and/or DM have different peripheral and central ambulatory blood pressure profiles compared to those with primary kidney disease?
Patients with ESRD due to hypertension or diabetes exhibit significantly higher peripheral and central ambulatory blood pressures during the interdialytic period compared to those with primary kidney disease.
Higher interdialytic peripheral/central BP in ESRD from hypertension/diabetes; leaves open whether etiology-specific patterns alter outcomes or management.
Aim. To study peripheral and central ambulatory hemodynamics during the 44-hour interdialytic period in patients with different etiology of end-stage renal disease (ESRD) Methods. 68 patients with ESRD receiving renal replacement therapy underwent 44-hour interdialytic ambulatory measurement of aortic and brachial artery blood pressure using a validated oscillometric technology Vasotens BPLab (OOO “Petr Telegin”,Nizhny Novgorod). The obtained results were estimated using the Mann-Whitney test depending on the etiology of ESRD (i.e. as a result of primary kidney disease or arterial hypertension (AH) and/or diabetes mellitus (DM). p<0.05 wasconsideredstatistically significant. Results. Elevated levels of clinical systolic BP (SBP) before (156 [143; 168] and 146 [136; 155] mm Hg) and after the initiation of hemodialysis (154 [140; 169] and 146 [137; 155] mm Hg; p<0.05) were commonly found in patients with ESRD secondary to AH and/or DM compared with those patients with ESRD caused by primary kidney disease. This group of patients demonstrated elevated 44-hour peripheral SBP (149 [138; 160] and 139 [132; 147] mm Hg), pulse BP (PBP) (65 [56; 74] and 60 [54; 66] mm Hg), central nocturnal SBP (132 [122; 143] and 125 [116; 133] mm Hg); p<0.05. Peripheral (152 [141; 163] and 147 [136; 158] mm Hg) and central SBP (137 [125; 148] and 131 [121; 141] mm Hg) were higher in the group of patients with ESRD due to AH and/or DM on day 2 after hemodialysis initiation compared to those on day 1; p<0.05. Peripheral and central daily and nocturnal SBP and pulse BP were also elevated. Patients with primary kidney disease had elevated nocturnal central SBP on day 2 after hemodialysis initiation compared to those on day 1 (131 [121; 142] and 126 [116; 135] mm Hg, p<0.05). Conclusion. Patients with ESRD secondary to AH and/or DM had higher levels of clinical SBP before and after hemodialysis initiation, as well as ambulatory peripheral and central SBP and pulse BP during both, the 44-hour interdialytic period and on interdialytic days 1-2, compared with patients with primary kidney diseases. In addition, patients in this group demonstrated elevated peripheral and сentral SBP and PBP on day 2 after hemodialysis initiation compared with those on day 1.
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Труханова et al. (2018) conducted an observational in End-stage renal disease (n=68). ESRD secondary to arterial hypertension and/or diabetes mellitus vs. ESRD secondary to primary kidney disease was evaluated on Clinical systolic blood pressure before hemodialysis (mm Hg) (p=<0.05).
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