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Effect of Improving Volume Overload on Home Blood Pressure Variability in Hemodialysis Patients.

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机构: [1]Capital Medical University, Beijing, China. [2]Department of Nephrology, Beijing Tian-Tan Hospital, Capital Medical University, Beijing, China. [3]Department of Nephrology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
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关键词: Bioimpedance Dry weight Hemodialysis Home blood pressure variability Volume overload

摘要:
Blood pressure variability is an independent predictor of adverse clinical events in hemodialysis patients. Volume overload is one of the most important factors affecting blood pressure homeostasis. In the present study, we explored the effects of dry weight reduction on home blood pressure variability in volume overload hemodialysis patients. Hemodialysis patients with volume overload had their dry weight gradually decreased under the guidance of bioimpedance methods, which was represented by calf-bioimpedance ratio (Calf-BR). Home blood pressure was measured on waking up and at bedtime for 1 week at baseline and at the end of the two-month study. Coefficient of variation was used to define home blood pressure variability. Thirty-eight hemodialysis patients had their dry weight significantly decreased from 60.7 ± 11.3 to 59.6 ± 10.7 kg (P = 0.003) accompanied with a significant reduction in calf-BR (0.828 ± 0.023 vs. 0.786 ± 0.020, P<0.001). The systolic and diastolic blood pressure decreased significantly. Moreover, the whole-day, morning, and evening systolic blood pressure variability gradually and significantly decreased by the end of the study (5.6 ± 2.1% versus 4.0 ± 1.7%, P<0.001; 7.7 ± 3.5% vs. 6.3 ± 2.7%, P = 0.005; 7.5 ± 2.8% vs. 5.9 ± 2.3%, P = 0.002, respectively). Diastolic blood pressure variability parameters were unchanged. The interdialytic weight gain and the incidence of adverse events were similar throughout the study period. Gradual dry weight reduction by bioimpedance methods improved home blood pressure variability in hemodialysis patients with chronic fluid overload. © 2019 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.

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出版当年[2018]版:
大类 | 4 区 医学
小类 | 4 区 血液学 4 区 泌尿学与肾脏学
最新[2023]版:
大类 | 4 区 医学
小类 | 4 区 血液学 4 区 泌尿学与肾脏学
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出版当年[2017]版:
Q4 UROLOGY & NEPHROLOGY Q4 HEMATOLOGY
最新[2023]版:
Q3 HEMATOLOGY Q3 UROLOGY & NEPHROLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2017版] 出版当年五年平均 出版前一年[2016版] 出版后一年[2018版]

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第一作者机构: [1]Capital Medical University, Beijing, China.
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通讯机构: [2]Department of Nephrology, Beijing Tian-Tan Hospital, Capital Medical University, Beijing, China. [*1]Department of Nephrology, Beijing TianTan Hospital, Capital Medical University, No 119 South 4th Ring West Road, Fengtai District, Beijing 100070, China.
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