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Abstract: TH-PO432

48-Hour Ambulatory BP (ABPM) Monitoring and the Estimated Risk of Death in the Hemodialysis Population: A Multicenter, International Study

Session Information

Category: Hypertension and CVD

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

Author

  • Mallamaci, Francesca, G.O.M. Bianchi Melacrino Morelli Reggio Calabria, Reggio Calabria, Italy

Group or Team Name

  • on behalf of the TACTIC study working group*
Background

ABPM extended to 44h or 48h has been proposed by consensus documents by the ASN and the ESH and the ERA-EDTA (EURECAm) as the ideal metric for estimating the BP-related health burden in ESRD but information on the relationship between this metric and the risk of death is still restricted to a limited number of single center studies.

Methods

We investigated the relationship between 48h ABPM and the probability of death as estimated by the ARO risk score in a cohort of 278 hemodialysis patients in 7 centers in 3 European countries. The ARO risk score is a well-validated instrument based on 14 risk factors for death specific to the hemodialysis population (KI 87, 996–1008, 2015).

Results

Average 48h diastolic BP robustly correlated in an inverse fashion with the estimated risk of death at 1 year (r=-0.350, P<0.001) and at 2 years (r=-0.331, P<0.001) and these associations were confirmed in separate analyses of day-time and night-time average values (P<0.001). Furthermore, 48h pulse pressure was a direct predictor of the estimated death risk at 1 year (r=0.330, P<0.001) and at 2 years (r=0.293, P<0.001) and again this metric predicted the estimated risk of death in separate analyses of day and night time recordings.

Conclusion

In a multicenter study in 3 countries 48h diastolic and Pulse Pressure correlated strongly with the estimated risk of death and this was true for both average day-time and night-time values. Extended ABPM recordings reflect the health burden of BP in the hemodialysis population.

*Torino C, Sarafidis PA, Ekart R, Loutradis C, Karpetas A, Raptis V, Bikos A, Papagianni A, Balafa O, Siamopoulos K, Pisani G, Morosetti M, Del Giudice A, Aucella F, Di Lullo L, Battaglia G, Tripepi R, Tripepi G, London G, Zoccali C.