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Abstract: FR-PO822

Blood Pressure Variability along Hemodialysis: Is It Related to Mortality?

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Baamonde, Eduardo, Hospital General Universitario de Gran Canaria Dr Negrin, Las Palmas, Spain
  • Oliva-Damaso, Elena, Hospital General Universitario de Gran Canaria Dr Negrin, Las Palmas, Spain
  • Vega-diaz, Nicanor, Hospital General Universitario de Gran Canaria Dr Negrin, Las Palmas, Spain
  • Gallego Samper, Roberto, Hospital Universitario de Gran Canaria Dr Negrin, Las Palmas de Gran Canaria, Spain
  • Oliva-Damaso, Nestor, Hospital Costa del Sol, Marbella, Spain
  • Marrero- Robayna, Silvia, Hospital General Universitario de Gran Canaria Dr Negrin, Las Palmas, Spain
  • Rodriguez-Perez, Jose C., Hospital General Universitario de Gran Canaria Dr Negrin, Las Palmas, Spain
Background

Recent studies, link Hemodialysis systolic blood pressure (BP) variability and mortality . However BP variability can be seen with different (BP) components, including systolic and diastolic as well as predialysis, intradialytic, and postdialysis BP.
Aims: To analyze BP variability in different measurements along Hemodialisys (HD) session and verify which of them predict mortality in incident patients.

Methods

Retrospective analysis of 277 incidents patients on conventional HD. BP records were collected throughout the hemodialysis sessions from the beginning of treatment. BP variability was calculated using the coefficient of variation (CV). Demographic and clinical data were analyzed during a 24 month follow-period as well as mortality rate. Survival analisys (Cox proportional hazards) was carried out by stratifying patients in tertiles of BP variability.

Results

277 incident HD patiens (186 M, 91 F). Age (yr): 65,1 ± 13,1. Sex (%men): 67,1. Diabetes (%): 45,8. Hypertension (%): 95. Systolic preHD BP (mmHg): 137,6 ± 14,5 CV: 11,5 ± 3,7, Diastolic preHD BP (mmHg): 73,3 ± 6,8. CV:12,1 ± 7,7. Systolic postHD BP(mmHg) : 137,2 ± 14,7. CV: 11,2 ± 3,05. Diastolic postHD BP: 73,5 ± 6,5. CV: 13,5 ± 14,5. We observed 51 deaths (18,4%) during the follow-up period. Higher Diastolic post hemodialisys blood pressure variability (DBPV) was associated with an increased risk of death, as shown in the table below (Fig1). Survival analysis (Kaplan-Meyer) shows significative differences between tertiles of DBPV (p<0.009) (Fig2).

Conclusion

In our study we observed and increased risk of mortality in patients with higher diastolic blood pressure variability, especially those with greater variability post hemodialysis.