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Abstract: TH-PO477

Association Between Post-Dialysis Blood Pressure and Extracellular Volume Status in Hemodialysis Patients

Session Information

Category: Hypertension and CVD

  • 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention

Authors

  • Choi, Hoon Young, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
  • Kim, Seok-hyung, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
  • Kim, Hyunwook, Yonsei University College of Medicine Gangnam Severance Hospital, Seoul, GYEONGGI-DO, Korea (the Republic of)
  • Lee, Jung eun, Yongin Severance Hospital, Yongin-si, Korea (the Republic of)
  • Kim, Hyung Jong, Bundang CHA Medical Center, CHA University, Seongnam, GYEONGGI-DO, Korea (the Republic of)
  • Park, Hyeong cheon, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
Background

Volume status and hypertension are closely associated with cardiovascular outcome in receiving hemodialysis (HD) patients. New noninvasive bedside tools, such as bioimpedance analysis (BIA) has been reported to assess objective fluid status. Aim of the study was to ascertain the association between hydration status measured by BIA and postdialysis blood pressure in HD patients.

Methods

We conducted a cross-sectional multi-center study. All patients underwent a postdialysis BIA to assess hydration status which was calculated by the ratio of extracellular water (ECW) to total body water(TBW). Patients were divided into three groups, those in whom the blood pressure decreased during dialysis by≥20mm Hg (PDHYPO), those in whom the SBP increased by≥10mmHg (PDHYPER), and in whom the SBP did not meet the definitions of intradialytic hypotension or hypertension, termed as PDSTABLE group. DeltaSBP was calculated by SBP difference between before and after HD. Laboratory data including dialysate sodium as well as serum sodium level was collected and subjective global assessment (SGA) was used for assessing nutritional status.

Results

A total of 254 prevalent HD patients were included in this study. Fifty-four patients (21.3 %) had PDHYPO and seventy-four patients (39.2%) had PDHYPER. Age, SBP after dialysis (SBPpost), and deltaSBP were significantly higher, while hemoglobin, serum albumin and sodium and SGA were lower in the PDHYPER group than in PDHYPO and PDSTABLE group. The PDHYPER group showed higher ECW/TBW than in PDHYPO and PDSTABLE group. (0.414 ± 0.011 vs. 0.402 ± 0.012, 0.406 ± 0.02, p<0.001). In spearman correlation coefficient, deltaSBP (r=+0.231, p<0.001) and phase angle (r=-0.804, p<0.001) showed a significant correlation with ECW/TBW. In multiple logistic regression analysis, older age, lower SGA, lower albumin, and higher ECW/TBW were the independent risk factors affecting PDHYPER.

Conclusion

Our data support that increased ECW/TBW is significantly associated with postdialysis blood pressure in HD patients.