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Ambulatory blood pressure monitoring in haemodialysis and continuous ambulatory peritoneal dialysis (CAPD) patients

Abstract

The aim of this study was to compare the results of the 44-h ambulatory blood pressure monitoring (ABPM) data between haemodialysis (HDp) and CAPD patients and to investigate the relation of circadian rhythm in blood pressure (BP) with development of left ventricular hypertrophy. Twenty-two HDp (11 male, 11 female, mean age: 50 ± 17 years) and 24 CAPDp (11 male, 13 female, mean age: 47 ± 15 years) were included. Echocardiographic measurements and ABPM were performed in all study groups. ABPM of the first and second days were analysed separately and compared with CAPDp. Left ventricular hypertrophy was detected in 17 of the 22 HDp (77%) and 17 of the 24 CAPDp (71%). There was no significant differences between HD and CAPDp in respect to 44-h, daytime and night-time systolic and diastolic BP values. Although the course of BP in CAPDp was stable during the 44-h period, systolic and diastolic BP levels on the second day were significantly higher than those of on the first day in HDp (P < 0.001 for both). Daytime systolic and diastolic BP levels on the first day in HD group were recorded lower than those of theCAPD group. On the second day, night-time BP readings (both systolic and diastolic BP) were measured significantly higher in the HD group compared with the CAPD group. Twenty-one of the 24 (88%) CAPD patients were dippers, whereas only four of the 22 (18%) HDp were dippers (P < 0.001). Dipper patients had significantly lower left ventricular mass index (LVMI) than non-dipper patients (131 ± 29 g/m2 vs 153 ± 40 g/m2, P = 0.03). In 44-h ABPM, there were no differences in daytime and night-time systolic and diastolic blood pressures between HD and CAPD patients. Non-dipper patients had increased LVMI as compared with dipper patients. Abnormalities in circadian rhythm of the blood pressure might be one of the implicated factors for development of left ventricular hypertrophy.

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References

  1. Katzarski KS et al. Fluid state and blood pressure control inpatients treated with long and short haemodialysis Nephrol Dial Transplant 1999; 14: 369–375

    Article  CAS  Google Scholar 

  2. Alvarez-Lara MA et al. Blood pressure and body water distribution in chronic renal failurepatients Nephrol Dial Transplant 2001; 16 (Suppl 1): 94–97

    Article  Google Scholar 

  3. Gunal AI et al. Strict volume control normalizes hypertension in peritoneal dialysispatients Am J Kidney Dis 2001; 37: 588–593

    Article  CAS  Google Scholar 

  4. Amar J et al. Nocturnal blood pressure and 24-hour pulse pressure are potent indicators of mortality in hemodialysispatients Kidney Int 2000; 57: 2485–2491

    Article  CAS  Google Scholar 

  5. Erturk S et al. Relationship of ambulatory blood pressure monitoring data to echocardiographic findings in hemodialysispatients Nephrol Dial Transplant 1996; 11: 2050–2054

    Article  CAS  Google Scholar 

  6. Lingens N et al. Ambulatory blood pressure monitoring in paediatricpatients treated by regular haemodialysis and peritoneal dialysis Pediatr Nephrol 1995; 9: 167–172

    Article  CAS  Google Scholar 

  7. Verdecchia P et al. Blunted nocturnal fall in blood pressure in hypertensive women with future cardiovascular morbid events Circulation 1993; 88: 986–992

    Article  CAS  Google Scholar 

  8. Coomer RW, Schulman G, Breyer JA, Shyr Y . Ambulatory blood pressure monitoring in dialysispatients and estimation of mean interdialytic blood pressure Am J Kidney Dis 1997; 29: 678–684

    Article  CAS  Google Scholar 

  9. Rodby RA, Vonesh EF, Korbet SM . Blood pressures in hemodialysis and peritoneal dialysis using ambulatory blood pressure monitoring Am J Kidney Dis 1994; 23: 401–411

    Article  CAS  Google Scholar 

  10. Declaration of Helsinki. Recommendations Guiding Physicians in Biomedical Research Involving Human Subjects 41st World Medical Assembly, Hong Kong September 1989

  11. Henry WL et al. Report of the American Society of Echocardiography Committe on nomenculature and standarts in two dimensional echocardiography Circulation 1980; 62: 212–217

    Article  CAS  Google Scholar 

  12. Sahn DJ, DeMaria A, Kisslo J, Weyman A . Recommendations regarding quantitation in M Mode echocardiographic measurements Circulation 1978; 58: 1072–1083

    Article  CAS  Google Scholar 

  13. Devereux RB et al. Methods for detection of left ventricular hypertrophy: application to hypertensive heart disease Eur Heart J 1993; 14 (Suppl D): 8–15

    Article  Google Scholar 

  14. Devereux RB, Reichek N . Echocardiographic determination of left ventricular mass in men. Anatomic validation of the method Circulation 1977; 55: 613–618

    Article  CAS  Google Scholar 

  15. Staessen JA, Bieniaszewski L, O Brien ET, Fagard R . What is normal blood pressure on ambulatory monitoring? Nephrol Dial Transplant 1996; 11: 241–245

    Article  CAS  Google Scholar 

  16. Velasquez MT et al. Control of hypertension is better during hemodialysis than during continuous ambulatory peritoneal dialysis in ESRDpatients Clin Nephrol 1997; 48: 341–345

    CAS  PubMed  Google Scholar 

  17. Sturrock ND et al. 4 Non-dipping circadian blood pressure and renal impairment are associated with increased mortality in diabetes mellitus Diabet Med 2000; 17: 360–364

    Article  CAS  Google Scholar 

  18. White WB . How well does ambulatory blood pressure predict target-organ disease and clinical outcome inpatients with hypertension? Blood Press Monit 1999; 4 (Suppl 2): S17–S21

    PubMed  Google Scholar 

  19. Korzets Z, Erdberg A, Galan E, Bernheim J . Does diurnal variation in blood pressure exist in CAPD patients? Nephrol Dial Transplant 1994; 9: 274–276

    CAS  PubMed  Google Scholar 

  20. Farmer CK et al. An investigation of the effect of advancing uraemia, renal replacement therapy and renal transplantation on blood pressure variability Nephrol Dial Transplant 1997; 12: 2301–2307

    Article  CAS  Google Scholar 

  21. Cocchi R et al. Prevalence of hypertension inpatients on peritoneal dialysis: results of an Italian multicentre study Nephrol Dial Transplant 1999; 14: 1536–1540

    Article  CAS  Google Scholar 

  22. Chazot C et al. Interdialysis blood pressure control by long haemodialysis sessions Nephrol Dial Transplant 1995; 10: 831–837

    CAS  PubMed  Google Scholar 

  23. Covic A, Goldsmith DJ, Covic M . Reduced blood pressure diurnal variability as a risk factor for progressive left ventricular dilatation in hemodialysispatients Am J Kidney Dis 2000; 35: 617–623

    Article  CAS  Google Scholar 

  24. London GM, Drüeke TB . Atherosclerosis and arteriosclerosis in chronic renal failure Kidney Int 1997; 51: 1678–1695

    Article  CAS  Google Scholar 

  25. London GM et al. Cardiac and arterial interactions in end-stage renal disease Kidney Int 1996; 50: 600–608

    Article  CAS  Google Scholar 

Download references

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Correspondence to A Yildiz.

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Tonbul, Z., Altintepe, L., Sözlü, Ç. et al. Ambulatory blood pressure monitoring in haemodialysis and continuous ambulatory peritoneal dialysis (CAPD) patients. J Hum Hypertens 16, 585–589 (2002). https://doi.org/10.1038/sj.jhh.1001449

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