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Abstract: FR-PO820

Long-Term Blood Pressure Variability Better Predicts All-Cause Mortality in Hemodialysis Patients than Intradialytic Blood Pressure Variability

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Liao, Ruoxi, West China Hospital, Sichuan University, Chengdu, China
  • Lin, Li Ping, West China Hospital, Sichuan University, Chengdu, China
  • Li, Jiameng, West China Hospital of Sichuan University, Chengdu, China
  • Xiong, Yuqin, West China Medical School, West China Hospital, Sichuan University, Chengdu, SICHUAN, China
  • Li, Yupei, West China Hospital, Sichuan University, Chengdu, China
  • Su, Baihai, West China Hospital of Sichuan University, Chengdu, China
Background

Blood pressure variability (BPV) is a potential prognostic predictor for all-cause mortality. Here we conducted a retrospective cohort study to compare the affecting factors and prognostic ability of long-term BPV with intradialytic BPV in hemodialysis(HD) patients.

Methods

We included 611 HD patients, collected their baseline characteristics including one-year blood pressure, and followed up for 40 months. Long-term BPV was assessed by pre-dialysis SBP residual metric, while intradialytic BPV was assessed by intradialytic absolute SBP residual.

Results

Long-term BPV showed a correlation with intradialytic BPV (Spearman r from 0.5997 to 0.6883). According to logistic regression, both long-term and intradialytic BPV were associated with age, vascular access type, dialysis time, dialysis vintage, pre-dialysis blood pressure and serum albumin(Alb), while only intradilytic BPV was affected by body mass index (Fig 1 A-D). High long-term BPV but not intradialytic BPV was associated with high all-cause mortality (p= 0.0047 and 0.3682, respectively)(Fig 1 E-F). According to receiver operating characteristic (ROC) curve with mortality as dependent variable, long-term SBP residual metric showed a stronger prognostic ability than intradialytic BPV (area under curve [AUC] 0.679 vs. 0.568, p=0.0381), which was more significant in patients with blood pressure≥140/90mmHg (AUC 0.713 vs. 0.556, p=0.0191)(Fig1 G-H). After complete adjustments, long-term BPV remained significantly associated with all-cause mortality (hazard ratio 1.628 per quartile; 95% confidence interval, 1.086 to 2.441).

Conclusion

Our results implied an advantage of long-term BPV in predicting all-cause mortality in HD patients, suggesting long-term BPV as an additional target of blood pressure management.

Fig 1. Affecting factors and prognostic ability of intradialytic and long-term BPV

Funding

  • Government Support - Non-U.S.