Hemodialysis access type is associated with blood pressure variability and echocardiographic changes in end-stage renal disease patients

2019 ◽  
Vol 32 (4) ◽  
pp. 627-634 ◽  
Author(s):  
Ruoxi Liao ◽  
Liya Wang ◽  
Jiameng Li ◽  
Liping Lin ◽  
Si Sun ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Blood Pressure Variability ◽  
Hemodialysis Access ◽  
Stage Renal Disease ◽  
End Stage

Abstract 498: Increased Blood Pressure Variability and Baroreflex Impairment in Patients With End-stage Renal Disease Undergoing Hemodialysis

Hypertension ◽  
2013 ◽  
Vol 62 (suppl_1) ◽  
Author(s):  
Kátia B Scapini ◽  
Valéria C Hong ◽  
Janaína B Ferreira ◽  
Sílvia B Souza ◽  
Naomi V Ferreira ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Blood Pressure Variability ◽  
Baroreflex Sensitivity ◽  
Low Frequency ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients ◽  
Alpha Index

Background: Patients with end-stage renal disease (ESRD) undergoing hemodialysis are susceptible to the development of autonomic dysfunction, which is associated with an increased risk of sudden death. Experimental and clinical evidence suggest a crucial role of autonomic dysfunction for both, the progression of renal disease and for the high rate of cardiovascular events in these patients. In the present study, we evaluated the heart rate variability (HRV), the blood pressure variability (BPV) and the baroreflex sensitivity (BRS) in ESRD patients undergoing hemodialysis and normal controls. Methods: Nine ESRD patients undergoing hemodialysis (mean age 53.4±10.2 years, 4 male) and nine age-matched healthy controls (mean age 52.8±10.2 years, 4 male) were assessed. Non−invasive curves of blood pressure (BP) were recorded continuously (Finometer ®) for 10 minutes, at rest, in the supine position. The heart rate variability (HRV) and systolic blood pressure variability (BPV) were estimated in the time and frequency domain (spectral analysis). The BRS was quantified by alpha index. Statistical analyzes were performed by Student's t test and the results were expressed as mean ± standard deviation. Results: ESRD patients presented lower HRV in time domain than healthy controls (SDNN: 25.8±10.7 vs. 44.6±11.7 ms, p<0.01; VAR NN: 768.3±607.4 vs. 2113.9±1261.6 ms 2 , p=0.01). All frequency domain analyzed indexes, i.e., total power (361.9±297.0 vs. 1227.2±696.3 ms 2 , p<0.01), high-frequency (181.8±128.7 vs. 358.7±179.8 ms 2 , p=0.047), low-frequency (55.1±44.2 vs. 444.6±389.9 ms 2 , p=0.02) and very-low-frequency (72.5±75.1 vs. 279.2±119.5 ms 2 , p<0.01) of HRV were lower in ESRD patients. The BPV was higher in ESRD patients when compared to controls (VAR PAS: 98.4±72.0 vs. 35.4±21.4 ms 2 , p=0.03) and BRS was lower in ESRD patients (alpha index: 4.34±3.05 vs. 7.56±2.50 ms/mmHg, p<0.02). Conclusion: ESRD patients undergoing hemodialysis presents reduced HRV, increase in BPV and reduced baroreflex sensitivity. These impairments may be associated with mortality in ESRD.

scholarly journals Blood pressure variability as an adverse prognostic risk factor in end-stage renal disease

1999 ◽  
Vol 14 (8) ◽  
pp. 1976-1981 ◽  
Author(s):  
Masahiko Tozawa ◽  
Kunitoshi Iseki ◽  
Shinichiro Yoshi ◽  
Koshiro Fukiyama
Keyword(s):  
Blood Pressure ◽  
Risk Factor ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Blood Pressure Variability ◽  
Stage Renal Disease ◽  
End Stage

Blood Pressure Variability and Mortality in end Stage Renal Disease

2012 ◽  
Vol 8 (4) ◽  
pp. 276-281
Author(s):  
Maria L. Sirico ◽  
Serena Torraca ◽  
Lucia Di Micco ◽  
Biagio Di Iorio
Keyword(s):  
Blood Pressure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Blood Pressure Variability ◽  
Stage Renal Disease ◽  
End Stage

Blood Pressure Variability and Mortality in end Stage Renal Disease

2012 ◽  
Vol 8 (4) ◽  
pp. 276-281
Author(s):  
Maria L. Sirico ◽  
Serena Torraca ◽  
Lucia Di Micco ◽  
Biagio Di Iorio
Keyword(s):  
Blood Pressure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Blood Pressure Variability ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Association Between Systolic and Diastolic Blood Pressure Variability and the Risk of End-Stage Renal Disease

Hypertension ◽  
2019 ◽  
Vol 74 (4) ◽  
pp. 880-887 ◽  
Author(s):  
Eun Hui Bae ◽  
Sang Yup Lim ◽  
Kyung-Do Han ◽  
Tae Ryom Oh ◽  
Hong Sang Choi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Disease ◽  
Diastolic Blood Pressure ◽  
End Stage Renal Disease ◽  
Blood Pressure Variability ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Effects of Variability in Blood Pressure, Glucose, and Cholesterol Concentrations, and Body Mass Index on End-Stage Renal Disease in the General Population of Korea

2019 ◽  
Vol 8 (5) ◽  
pp. 755 ◽  
Author(s):  
Mee Kyoung Kim ◽  
Kyungdo Han ◽  
Hun-Sung Kim ◽  
Yong-Moon Park ◽  
Hyuk-Sang Kwon ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
General Population ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
High Variability ◽  
Metabolic Parameters ◽  
Metabolic Parameter ◽  
Stage Renal Disease ◽  
End Stage

Aim: Metabolic parameters, such as blood pressure, glucose, lipid levels, and body weight, can interact with each other, and this clustering of metabolic risk factors is related to the progression to end-stage renal disease (ESRD). The effect of variability in metabolic parameters on the risk of ESRD has not been studied previously. Methods: Using nationally representative data from the Korean National Health Insurance System, 8,199,135 participants who had undergone three or more health examinations between 2005 and 2012 were included in this analysis. Intraindividual variability in systolic blood pressure (SBP), fasting blood glucose (FBG), total cholesterol (TC), and body mass index (BMI) was assessed by examining the coefficient of variation, variability independent of the mean, and average real variability. High variability was defined as the highest quartile of variability and low variability was defined as the lower three quartiles of variability. Results: Over a median (5–95%) of 7.1 (6.5–7.5) years of follow-up after the variability assessment period, 13,600 (1.7/1000 person-years) participants developed ESRD. For each metabolic parameter, an incrementally higher risk of ESRD was observed for higher variability quartiles compared with the lowest quartile. The risk of ESRD was 46% higher in the highest quartile of SBP variability, 47% higher in the highest quartile of FBG variability, 56% higher in the highest quartile of BMI variability, and 108% higher in the highest quartile of TC variability. Compared with the group with low variability for all four parameters, the group with high variability for all four parameters had a significantly higher risk for incident ESRD (hazard ratio (HR) 4.12; 95% CI 3.72–4.57). Conclusions: Variability in each metabolic parameter was an independent predictor of the development of ESRD among the general population. There was a composite effect of the variability in additional metabolic parameters on the risk of ESRD.

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