Abstract: FR-PO0565
Which Blood Pressure Measurement Matters in Patients on Peritoneal Dialysis? Important Insights from an Observational Cohort Study
Session Information
- Home Dialysis: Clinical Epidemiology
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Wang, Angela Yee Moon, Singapore General Hospital, Singapore, Singapore
- Tang, Tak Ka, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, (past institution where this research was done), Hong Kong
- Cheung, Simon, Queen Elizabeth Hospital, Hong Kong, Hong Kong
- Lo, Stanley, Pamela Youde Nethersole Eastern Hospital, Hong Kong, (past institution where this research was done), Hong Kong
Background
KDIGO suggested using ambulatory blood pressure (AMBP) to complement standardized BP in managing BP of patients with CKD. However, there is little data in patients doing peritoneal dialysis (PD). We performed this prospective observational study with the primary objective to evaluate different measures with AMBP that best predict clinical outcomes in PD patients and compare that with clinic BP.
Methods
235 patients (mean age: 59 ± 12, 57.9% men, 52.3% diabetes) stable on PD were recruited from 3 regional hospitals. All underwent clinic BP measurement twice after resting for 15minutes to give an average clinic BP and also underwent 24-hour home AMBP. They were then prospectively followed up for study outcomes: i) all-cause mortality, major adverse cardiovascular events (MACE), and 3-point MACE which included non-fatal myocardial infarction, non-fatal stroke, and fatal cardiovascular events.
Results
During a mean ± SD follow up of 57.3 ± 27.1months, 35.3% had died and 76 patients had 3-point MACE. Those who died had higher daytime (147 ± 20mmHg) & nighttime average (av) SBP (144 ± 24mmHg) compared to those who survived (daytime av SBP: 138 ± 16mmHg; P<0.001) & (nighttime av SBP: 132 ± 22mmHg; P<0.001). The 24-hour av SBP was also higher for those who died vs those who survived (P<0.001). Similar significant difference was observed when compared daytime, nighttime & 24-hour SBP between patients with 3-point MACE vs those without. But no difference was observed in daytime, nighttime, or 24-hour av DBP between the two groups. Clinic SBP and DBP did not differentiate between patients who died vs those who survived, nor between patients with & without 3-point MACE. Among the different AMBP readings, nighttime SBP showed the highest areas under the curves in predicting mortality, 3-point MACE and acute myocardial infarction/acute coronary events.
Conclusion
Ambulatory SBP is superior to clinic SBP in predicting mortality and MACE risk in PD patients. Among the different AMBP measures, nighttime SBP showed the strongest prediction with all-cause mortality and MACE risk in PD patients. These findings demonstrate the importance to perform AMBP to identify high risk PD patients and provide novel reference to target nighttime ambulatory SBP for clinical trial conduct in PD patients.
Funding
- Commercial Support – Baxter Extramural Grant Program