Document Detail


Determinants of mean arterial pressure and pulse pressure in chronic haemodialysis patients.
MedLine Citation:
PMID:  11687921     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hypertension is highly prevalent in the dialysis population, and has been implicated in the pathogenesis of the observed excess of cardiovascular morbidity and mortality in these patients. Nevertheless, there are no reports on the clinical and biochemical determinants of both pulse pressure (PP) and mean arterial pressure (MAP) in dialysis populations. A total of 541 haemodialysed patients from 11 dialysis centres were included in the study. The demographic, clinical, and biological characteristics were recorded. Both pre- and post- dialytic blood pressures (systolic and diastolic) were measured. PP and MAP were calculated. Mean predialytic PP was 67 +/- 17 mm Hg and significantly decreased after dialysis (60 +/- 18 mm Hg; P < 0.0001). In multivariate analysis, a 10 mm Hg increase in PP was positively associated with age (RR, 2.01; 95% CI, 1.35-5.01, for a 10-year increase in age), diabetes mellitus (RR, 1.08; 95% CI, 1.04-1.14), interdialytic weight gain (IWG) (RR, 1.84; 95% CI, 1.07-3.18, for 1% increase in IWG), and current smoking (RR, 2.59; 95% CI, 1.13-5.92) and negatively with Hb concentration (RR, 0.92; 95% CI, 0.84-0.99, for a 1 g/100 ml in Hb). Mean predialytic MAP was 98 +/- 15 mm Hg and significantly decreased after dialysis (91 +/- 16 mm Hg; P < 0.0001). In multivariate analysis, a 10 mm Hg increase in MAP was positively associated with parathyroid hormone (PTH) (RR, 1.32; 95% CI, 1.15-1.6, for 50 ng/ml in PTH), erythropoietin (EPO) treatment (RR, 1.09; 95% CI, 1.03-1.16), and current smoking (RR, 1.87; 95% CI, 1.39-2.41). PP and MAP are associated with different clinical parameters. Most of these factors are potentially reversible. Smoking cessation, correction of anaemia and limitation of IWG should be important challenges for physicians in care of dialysis patients.
Authors:
A B Abdelfatah; G Motte; D Ducloux; J M Chalopin
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of human hypertension     Volume:  15     ISSN:  0950-9240     ISO Abbreviation:  J Hum Hypertens     Publication Date:  2001 Nov 
Date Detail:
Created Date:  2001-11-05     Completed Date:  2001-12-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8811625     Medline TA:  J Hum Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  775-9     Citation Subset:  IM    
Affiliation:
Department of Nephrology, Dialysis, and Renal Transplantation, Saint Jacques Hospital, Besançon, France.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Blood Pressure / physiology*
Chronic Disease
Data Collection
Female
France / epidemiology
Humans
Kidney Diseases / physiopathology,  therapy
Male
Middle Aged
Multivariate Analysis
Prospective Studies
Renal Dialysis*
Risk Factors
Smoking / adverse effects

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


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