Document Detail


Shorter delivered dialysis times associate with a higher and more difficult to treat blood pressure.
MedLine Citation:
PMID:  23348881     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Shorter delivered dialysis times are associated with increased all-cause mortality. Whether shorter delivered dialysis times also associate with an increase in blood pressure (BP) and reduce the ability of probing dry weight to lower BP is unclear.
METHODS: Among patients participating in the Dry-Weight Reduction in Hypertensive Hemodialysis Patients (DRIP) trial, interdialytic ambulatory BP was recorded at baseline, 4 weeks and 8 weeks. Median intradialytic BP was also calculated at each dialysis treatment and associated with the delivered daily dialysis time.
RESULTS: The median time on dialysis at baseline was 3.6 h per treatment (range 2.5-4.5 h). At baseline, modeled median intradialytic systolic BPs were higher among those who received fewer hours of dialysis. Among subjects who did not have their dry weight probed (control group), the median intradialytic systolic BP continued to be elevated. Probing dry weight (ultrafiltration group) provoked a drop in median intradialytic systolic BP regardless of the delivered dialysis time. However, the reduction in BP was achieved after fewer sessions of dialysis when delivered dialysis was longer in duration. The pattern of change was confirmed using interdialytic ambulatory BP monitoring.
CONCLUSIONS: Fewer hours of delivered dialysis are associated with a higher systolic BP. Upon probing dry weight, compared with shorter dialysis treatment times, 4 h of delivered dialysis per session provokes reductions in systolic BP over fewer dialysis treatment sessions. Reduction of BP may lag dry-weight reduction when shorter dialysis is delivered.
Authors:
Teena Tandon; Arjun D Sinha; Rajiv Agarwal
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural     Date:  2013-01-24
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  28     ISSN:  1460-2385     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-06-19     Completed Date:  2014-01-23     Revised Date:  2014-06-03    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  1562-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure*
Blood Pressure Monitoring, Ambulatory
Body Weight / physiology
Cross-Sectional Studies
Female
Glomerular Filtration Rate
Humans
Hypertension / etiology*
Kidney Failure, Chronic / complications*,  therapy
Longitudinal Studies
Male
Middle Aged
Prognosis
Prospective Studies
Renal Dialysis / adverse effects*
Risk Factors
Time Factors
Grant Support
ID/Acronym/Agency:
2R01-DK062030-09/DK/NIDDK NIH HHS; R01 DK062030/DK/NIDDK NIH HHS
Comments/Corrections

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


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