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Ambulatory blood pressure profile and blood pressure variability in peritoneal dialysis compared with hemodialysis and chronic kidney disease patients

Hypertension Research volume 43, pages 903–913 (2020)Cite this article

Abstract

Hypertension in end-stage renal disease patients is highly prevalent and poorly controlled. Data on the ambulatory blood pressure (BP) profile and BP variability (BPV) in peritoneal dialysis (PD) patients are absent. This study examined the BP profile and BPV of patients undergoing PD in comparison with hemodialysis (HD) and predialysis chronic kidney disease CKD patients. Thirty-eight PD patients were matched for age, sex, and dialysis vintage with 76 HD patients and for age and sex with 38 patients with CKD stage 2–4. Patients under PD or HD underwent 48-h and CKD patients 24-h ambulatory BP monitoring. BP levels and BPV indices were compared for the 48-h, first and second 24 h, daytime and nighttime periods. Two-way mixed ANOVA for repeated measurements was used to evaluate the effects of dialysis modality and time on ambulatory BP in PD and HD. During all periods studied, SBP and DBP were numerically higher but not significantly different in PD than in HD patients. Systolic BP was significantly higher in PD or HD than in predialysis CKD (PD: 138.38 ± 20.97 mmHg; HD: 133.75 ± 15.5 mmHg; CKD: 125.52 ± 13.4 mmHg, p = 0.003), a difference evident also during daytime and nighttime periods. Repeated-measurements ANOVA showed no effect of dialysis modality on ambulatory BP during any period studied. All BPV indices studied were similar between PD and HD patients, in whom they were higher than in CKD individuals (first 24-h systolic-ARV: PD: 11.86 ± 3.19 mmHg; HD: 11.23 ± 3.45 mmHg; CKD: 9.81 ± 2.49 mmHg, p = 0.016). Average BP levels and BPV indices are similar between PD and HD patients, in whom they are higher than in their CKD counterparts. The dialysis modality has no effect on the ambulatory BP profile. These results suggest that PD is no better than HD with regard to overall BP control or BP fluctuations over time.

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Acknowledgements

The authors would like to express their gratitude to the doctors and nurses of the two departments of nephrology where the study was undertaken for their help.

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Authors and Affiliations

  1. Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Maria Eleni Alexandrou, Charalampos Loutradis, Maria Schoina, Georgios Tzanis, Chrysostomos Dimitriadis, Aikaterini Papagianni & Pantelis Sarafidis

  2. Department of Nephrology, Papageorgiou General Hospital, Thessaloniki, Greece

    Maria Eleni Alexandrou & Dorothea Papadopoulou

  3. Department of Cardiology, Papageorgiou General Hospital, Thessaloniki, Greece

    Vasileios Sachpekidis

  4. 3rd Department of Internal Medicine, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Εugenia Gkaliagkousi

  5. Department of Cardiovascular, Neural, and Metabolic Sciences, San Luca Hospital, Istituto Auxologico Italiano, Milan, Italy

    Gianfranco Parati

  6. Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy

    Gianfranco Parati

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  1. Maria Eleni Alexandrou
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Correspondence to Maria Eleni Alexandrou.

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Alexandrou, M.E., Loutradis, C., Schoina, M. et al. Ambulatory blood pressure profile and blood pressure variability in peritoneal dialysis compared with hemodialysis and chronic kidney disease patients. Hypertens Res 43, 903–913 (2020). https://doi.org/10.1038/s41440-020-0442-0

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