Is 44-hour better than 24-hour ambulatory blood pressure monitoring in hemodialysis?

The aim of this study is to evaluate if hemodialysis (HD) patients with similar blood pressure (BP) in the whole inter-HD period could have different target organ lesions and survival if the behavior of BP differs from the first to the second day of the inter-HD period. The present study compares 44-hour ambulatory BP monitoring (ABPM) patterns in 45 HD patients. Three BP patterns emerged: group A (n = 15) had similar BPs throughout (138 ± 11/88 ± 12 in the first 22 h vs. 140 ± 11/87 ± 12 mm Hg in the second 22-hour period); group B (n = 15) had a significant systolic BP rise from the first to the second period (132 ± 15/80 ± 12 vs. 147 ± 12/86 ± 13 mm Hg, p < 0.05); group C (n = 15) had significantly higher BPs (p < 0.05) than the other 2 groups throughout the whole inter-HD period, with no significant change between the 2 halves (172 ± 14/108 ± 12 vs. 173 ± 18/109 ± 14 mm Hg). Ventricular mass and survival during the 30-month follow-up period were statistically significantly better in group A, intermediate in group B and worse in group C. The data suggest that a 44-hour ABPM is more accurate than a 24-hour one in evaluating organ lesion and prognosis in HD patients. Copyright © 2006 S. Karger AG.

Keywords

Ambulatory blood pressure monitoring, Hemodialysis, Left ventricular hypertrophy, antihypertensive agent, calcitriol, erythropoietin, adult, anuria, blood pressure monitoring, clinical article, controlled study, female, follow up, heart left ventricle, heart left ventricle hypertrophy, heart ventricle, heart ventricle volume, hemodialysis, human, hypertension, male, priority journal, prognosis, statistical significance, survival rate, systolic blood pressure, treatment duration, Adult, Aged, Algorithms, Antihypertensive Agents, Blood Pressure Monitoring, Ambulatory, Echo-Planar Imaging, Electrocardiography, Female, Heart Rate, Humans, Hypertension, Kidney Failure, Chronic, Kidney Function Tests, Male, Middle Aged, Renal Dialysis, Survival Analysis