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Ambulatory blood pressure monitoring in hemodialysis patients

Shweta Shah, Sarah Swartz, Jessica Campbell, Poyyapakkam R Srivaths
BACKGROUND: Left ventricular hypertrophy (LVH) and arterial stiffness measured by pulse wave velocity (PWV) are independent predictors of cardiovascular (CV) mortality in adults receiving chronic dialysis. Hypertension strongly associates with elevated left ventricular mass index (LVMI) and PWV, with ambulatory blood pressure monitoring (ABPM), and central blood pressure (CBP) superior to office blood pressures (BP) in predicting CV morbidity. Few studies have described associations of office BP, ABPM, and CBP with LVMI and PWV in adolescent and young adult patients receiving hemodialysis (HD)...
February 18, 2019: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Athanasios Bikos, Elena Angeloudi, Evangelos Memmos, Charalampos Loutradis, Antonios Karpetas, Evi Ginikopoulou, Stylianos Panagoutsos, Ploumis Pasadakis, Vassilios Liakopoulos, Aikaterini Papagianni, Pantelis Sarafidis
BACKGROUND: Short-term blood pressure (BP) variability (BPV) is associated with increased cardiovascular risk in hemodialysis. Patients with intradialytic hypertension have high risk of adverse outcomes. Whether BPV is increased in these patients is not clear. The purpose of this study was to compare short-term BPV in patients with and without intradialytic hypertension. METHODS: Forty-one patients with and 82 patients without intradialytic hypertension (intradialytic SBP rise ≥10 mm Hg to > 150 mm Hg) matched in a 1: 2 ratio for age, sex, and hemodialysis vintage were included...
2018: American Journal of Nephrology
Ibrahim Dogan, Mucahit Yetim, Tolga Dogan, Huseyin Kayadibi, Mehmet Bertan Yilmaz, Baris Eser, Macit Kalcik, Yusuf Karavelioglu
PURPOSE: Cardiovascular diseases are the leading causes of mortality in chronic kidney disease. Spondin-2 (SP-2), an intrinsic cardio-protective factor, prevents maladaptive remodeling. We aimed to determine the relation between serum SP-2 levels and cardiac morphology along with inflammatory parameters in hemodialysis (HD) patients. METHOD: The study comprised a total of 95 patients (61 females) receiving HD treatment three times a week for at least 6 months, and a control group consisting of age and gender matched 62 subjects (34 females)...
November 2018: International Urology and Nephrology
Vasiliki Karava, Cherine Benzouid, Theresa Kwon, Marie-Alice Macher, Georges Deschênes, Julien Hogan
BACKGROUND: Increased interdialytic weight gain (IDWG) has been associated with poor outcomes in adults, but its impact on hemodialysis vasculopathy in children is unknown. METHODS: Nineteen patients (age 9 to 19 years old) with a median hemodialysis duration of 10.4 months were enrolled. Cardiovascular evaluation included left ventricular mass index (LVMI), pulse wave velocity (PWV), and carotid intima-media thickness (cIMT) measurements. PWV and cIMT were expressed as z-scores based on reference values in healthy children...
December 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Päivi M Pietilä-Effati, Anna K Salmela, M Juhani Koistinen
BACKGROUND Hypertension is a common complication of renal dialysis and is inadequately controlled in approximately one-third of patients. Intravascular renal denervation is an option to control sympathetic overdrive and decrease blood pressure. Four renal dialysis patients are presented with uncontrolled hypertension who were treated with intravascular renal denervation. CASE REPORT In a renal dialysis unit, patients were screened for therapy-resistant hypertension, which was defined as an outpatient blood pressure >160/100 mmHg and a blood pressure by interdialytic ambulatory blood pressure monitoring (ABPM) >130/80 mmHg...
August 21, 2018: American Journal of Case Reports
Christopher C Mayer, Julia Matschkal, Pantelis A Sarafidis, Stefan Hagmair, Georg Lorenz, Susanne Angermann, Matthias C Braunisch, Marcus Baumann, Uwe Heemann, Siegfried Wassertheurer, Christoph Schmaderer
BACKGROUND: Evidence on the utility of ambulatory BP monitoring for risk prediction has been scarce and inconclusive in patients on hemodialysis. In addition, in cardiac diseases such as heart failure and atrial fibrillation (common among patients on hemodialysis), studies have found that parameters such as systolic BP (SBP) and pulse pressure (PP) have inverse or nonlinear (U-shaped) associations with mortality. METHODS: In total, 344 patients on hemodialysis (105 with atrial fibrillation, heart failure, or both) underwent ambulatory BP monitoring for 24 hours, starting before a dialysis session...
September 2018: Journal of the American Society of Nephrology: JASN
Munekazu Ryuzaki
In the general population, hypertension (HT) is defined as systolic blood pressure (SBP) ≥140 mm Hg and/or diastolic blood pressure (DBP) ≥90 mm Hg. In dialysis patients, the definition is thought to be the same as in the general population. But there is no clear description about the definition of HT for dialysis patients, especially in peritoneal dialysis (PD) patients. The prevalence of HT in PD patients is much higher compared to the general population. The association of BP and cardiovascular (CV) mortality in PD patients who are not exposed to huge hemodynamic changes during hemodialysis (HD) has been inconsistently reported...
2018: Contributions to Nephrology
Amir Ahmad Nassiri, Legha Lotfollahi, Neda Behzadnia, Ilad Alavi Darazam, Monir Sadat Hakemi, Azam Rahimzadeh Kalaleh, Monir Kamalkhani
INTRODUCTION: Systemic arterial hypertension is prevalent in end-stage renal disease and is closely associated with left ventricular hypertrophy (LVH). Blood pressure (BP) behavior is unique in this population, and it is not clear which BP measurement should be used for treatment guidance. We aimed to evaluate the association of several methods of BP measurement with left ventricular mass index (LVMI) as hypertensive end-organ damage. MATERIALS AND METHODS: Patients on maintenance hemodialysis, 3 or 4 times per week for at least 3 months, were enrolled...
May 2018: Iranian Journal of Kidney Diseases
Yiduo Feng, Ziqian Li, Jing Liu, Fang Sun, Lijie Ma, Yang Shen, Yilun Zhou
OBJECTIVE: To investigate the association of short-term blood pressure variability (BPV) with cardiovascular mortality in hemodialysis (HD) patients, using a reliable index called average real variability (ARV), and to assess the factors associated with ARV in incident HD population. METHODS: A total of 103 HD patients were recruited, with 44-h ambulatory blood pressure monitoring performed after the midweek HD session. Systolic BPV was assessed by SD, coefficient of variation (CV), and ARV, respectively...
November 2018: Renal Failure
Joon-Sik Kim, Joo-Hark Yi, Jinho Shin, Yeon-Soo Kim, Sang-Woong Han
BACKGROUND: Hypertension and intradialytic hypotension are independent risk factors for mortality in hemodialysis patients. We hypothesized that intradialytic exercise would increase blood pressure (BP) during dialysis and decrease it during the postdialytic period. The present study aimed to investigate the effect of acute intradialytic exercise on BP both during dialysis and for 20 hours post-dialysis, and to detect any differences in effects of aerobic exercise (AE), resistance exercise (RE), and usual care (UC-the control condition)...
February 26, 2018: Journal of Sports Medicine and Physical Fitness
Lulu Wang, Mingming Zhao, Wenjin Liu, Xiurong Li, Hong Chu, Youwei Bai, Zhuxing Sun, Chaoqing Gao, Lemin Zheng, Junwei Yang
Mechanisms underlying elevated blood pressure in dialysis patients are complex as a variety of non-traditional factors are involved. We sought to explore the association of circulating betaine, a compound widely distributed in food, with blood pressure in dialysis patients. We used baseline data of an ongoing cohort study involving patients on hemodialysis. Plasma betaine was measured by high performance liquid chromatography in 327 subjects. Blood pressure level was determined by intradialytic ambulatory blood pressure monitoring...
February 2018: Journal of Clinical Hypertension
Vedran Premužić, Bojan Jelaković
Sexual dysfunction (SD) is common in men and women with chronic kidney disease (CKD) and is considered as an early marker for cardiovascular (CV) disease. We hypothesized that patients with SD have higher risk for vascular damage of the large arteries, accelerated vascular aging, and consequently higher CV mortality than other end-stage renal disease (ESRD) patients. In this study, the International Index of Erectile Function (IIEF) questionnaire and the Female Sexual Function Index (FSFI) questionnaire were applied in men and women, respectively...
February 2018: International Journal of Impotence Research
Jingjing Da, Zulong Zhang, Yan Shen, Qian Li, Ying Hu, Yan Zha
BackgroundPre-dialysis blood pressure variability (BPV) in adolescent and young-adult maintenance hemodialysis (MHD) patients remains unknown. This study aimed to show the degree of 44-h BPV and to explore its related risk factors in adolescent and young-adult MHD patients.MethodsOne hundred and fifty-three hemodialysis patients aged from 14 to 29 were selected from 11 medical facilities in Guizhou, China. Variability independent of the mean BP (VIM) obtained by 44-h ambulatory BP monitoring was used to calculate BPV...
March 2018: Pediatric Research
Antonios Karpetas, Charalampos Loutradis, Athanasios Bikos, Georgios Tzanis, Georgios Koutroumpas, Antonios A Lazaridis, Konstantinos Mavromatidis, Vassilios Liakopoulos, Aikaterini Papagianni, Pantelis Zebekakis, Luis M Ruilope, Gianfranco Parati, Pantelis A Sarafidis
OBJECTIVES: Patients with end-stage renal-disease under hemodialysis have increased cardiovascular risk and experience severe blood pressure (BP) fluctuations during the dialysis session and the subsequent interdialytic period. BP variability (BPV) may be an additional risk factor for cardiovascular events and preliminary data suggest increased BPV with advancing stages of chronic kidney disease. This is the first study to examine BPV during the whole intradialytic and interdialytic period in hemodialysis patients with ambulatory BP monitoring...
December 2017: Journal of Hypertension
Xiurong Li, Qingbo Jiang, Wenhui Wu, Xianlin Xu, Liying Miao, Lina Jin, Lina Xue, Tian Huang, Jia Di, Jinfeng Liu, Xiaozhou He
BACKGROUND: Ambulatory blood pressure (ABP) monitoring and carotid-femoral pulse wave velocity (cfPWV) provide important cardiovascular risk information for dialysis patients. This study aims to evaluate the risk factors of cfPWV and the associations between ambulatory blood pressure, especially night-time blood pressure and cfPWV. METHODS: We conducted a cross-sectional study in patients on maintenance hemodialysis. ABP and cfPWV were measured on a midweek interdialytic day...
February 2018: Clinical and Experimental Nephrology
Susanne Angermann, Marcus Baumann, Siegfried Wassertheurer, Christopher Clemens Mayer, Dominik Steubl, Christine Hauser, Yana Suttmann, Anna-Lena Reichelt, Robin Satanovskij, Georg Lorenz, Moritz Lukas, Bernhard Haller, Uwe Heemann, Timo Grimmer, Christoph Schmaderer
Cognitive impairment in hemodialysis patients is common and associated with adverse outcomes. So far, the underlying pathogenesis remains unclear. Therefore, we examined the potential relationship between cognitive impairment and three different categories of risk factors with particular focus on arterial stiffness measured by pulse wave velocity (PWV). A total of 201 chronic hemodialysis patients underwent cognitive testing under standardized conditions using the Montreal Cognitive Assessment (MoCA). Demographic data including cardiovascular risk factors, dialysis-associated factors as well as factors related to chronic kidney disease (CKD) were analyzed...
July 1, 2017: Clinical Science (1979-)
Wenjin Liu, Lei Jiang, Jianping Chen, Chaoqing Gao, Jianmei Zhou, Jiajun Zhou, Youwei Bai, Hong Chu, Wei Fan, Liang Wang, Zhuxing Sun, Xiurong Li, Junwei Yang
BACKGROUND: Adipokines are a set of cytokines secreted by white adipose tissue that have been suggested to be involved in the development of cardiovascular diseases. We aimed to evaluate the cross-sectional associations of a panel of representative adipokines with cardiovascular measures in a cohort of hemodialysis patients. METHODS: We measured plasma adiponectin, resistin, plasminogen activator inhibitor-1 (PAI-1), leptin, monocyte chemotactic protein 1 (MCP-1) and adipsin levels in 366 dialysis patients and 60 healthy controls...
2017: Nutrition & Metabolism
Pantelis A Sarafidis, Charalampos Loutradis, Antonios Karpetas, Georgios Tzanis, Alexia Piperidou, Georgios Koutroumpas, Vasilios Raptis, Christos Syrgkanis, Vasilios Liakopoulos, Georgios Efstratiadis, Gérard London, Carmine Zoccali
Arterial stiffness and augmentation of aortic blood pressure (BP) measured in office are known cardiovascular risk factors in hemodialysis patients. This study examines the prognostic significance of ambulatory brachial BP, central BP, pulse wave velocity (PWV), and heart rate-adjusted augmentation index [AIx(75)] in this population. A total of 170 hemodialysis patients underwent 48-hour ambulatory monitoring with Mobil-O-Graph-NG during a standard interdialytic interval and followed-up for 28.1±11.2 months...
July 2017: Hypertension
Wenjin Liu, Jiajun Zhou, Jianping Chen, Meijuan Meng, Xiurong Li, Chaoqing Gao, Jianmei Zhou, Liang Wang, Zhuxing Sun, Hong Chu, Wei Fan, Youwei Bai, Junwei Yang
OBJECTIVE: Ambulatory arterial stiffness index (AASI) is a parameter derived from ambulatory blood pressure (ABP) readings. It is calculated as 1 minus the linear slope of DBP on SBP. We tested its value in assessing arterial stiffness in dialysis patients. METHODS: We performed a cross-sectional analysis of the baseline data from a cohort study. A total of 344 patients on maintenance hemodialysis from six tertiary hospitals were included. All patients underwent ABP monitoring and carotid-femoral pulse wave velocity (cfPWV) measurement...
June 2017: Journal of Hypertension
Charalampos N Loutradis, Costas Tsioufis, Pantelis A Sarafidis
Hypertension (HT) is present in more than 80% of patients undergoing Hemodialysis (HD). Elevated Blood Pressure (BP) in hemodialysis patients is associated with cardiovascular events and mortality only when BP is recorded with home or ambulatory monitoring, since pre- and post-dialysis measurements are not valid estimates of BP levels during the interdialytic interval. Sodium and water overload is the most important of several mechanisms involved in HT development in HD. In this context, non-pharmacologic measures to ensure water and sodium balance by achieving patient dry weight and decreasing daily sodium intake, through modification of sodium level in the diet or in dialysis dialysate, are fundamental for HT control...
2017: Current Vascular Pharmacology
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