Document Detail


Achieving blood pressure targets during dialysis improves control but increases intradialytic hypotension.
MedLine Citation:
PMID:  18160959     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cardiovascular disease remains the most common cause of mortality in patients with end-stage kidney disease treated by regular hemodialysis. To improve blood pressure control and reduce cardiovascular risk, the United Kingdom Renal Association standards committee introduced pre- and post-dialysis target blood pressures of less than 140/90 and 130/80 mm Hg, respectively. We audited blood pressure control and symptomatic intradialytic hypotension requiring fluid resuscitation in the Greater London area renal centers that serve 2630 patients. The study captured 7890 hemodialysis sessions during a 1-week period where only 36% of the patients achieved the pre-dialysis target and 42% the post-dialysis target, with a wide variation between centers. Different antihypertensive medication prescriptions did not affect achievement of these targets. Fifteen percent of the patients suffered symptomatic hypotension requiring fluid resuscitation associated with significantly greater interdialytic weight gains. Our study found that intradialytic hypotension was significantly greater in centers that achieved better post-dialysis blood pressure targeting.
Authors:
A Davenport; C Cox; R Thuraisingham
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Publication Detail:
Type:  Journal Article     Date:  2007-12-26
Journal Detail:
Title:  Kidney international     Volume:  73     ISSN:  1523-1755     ISO Abbreviation:  Kidney Int.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-29     Completed Date:  2008-03-21     Revised Date:  2009-02-09    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  759-64     Citation Subset:  IM    
Affiliation:
UCL Center for Nephrology, Royal Free and University College Medical School, London, UK. andrew.davenport@royalfree.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Pressure*
Blood Pressure Determination / standards*
Cardiovascular Diseases / epidemiology
Female
Great Britain / epidemiology
Humans
Hypertension / epidemiology
Hypotension / epidemiology*
Kidney Diseases / therapy*
Male
Medical Audit
Middle Aged
Reference Values
Renal Dialysis / adverse effects*
Risk
Comments/Corrections
Comment In:
Kidney Int. 2008 Oct;74(7):963-4; author reply 964-5   [PMID:  18794820 ]
Kidney Int. 2008 May;73(9):1092; author reply 1092-3   [PMID:  18414439 ]
Kidney Int. 2008 Mar;73(6):667-8   [PMID:  18309346 ]
Kidney Int. 2008 Dec;74(12):1624; author reply 1624-5   [PMID:  19034307 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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