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Journal Info

  • Editor in Chief: Prof. Giovanni Gambaro
  • Co-Editor: Benedetta Bussolati
  • Current issue: Vol. 26 issue Suppl. 22 , 2013 (November-December)

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Vol. 26 - Issue 1 (January-February 2013)

Variability of blood pressure in dialysis patients: a new marker of cardiovascular risk

Variability of blood pressure in dialysis patients: a new marker of cardiovascular risk

J Nephrol 2013; 26(1): 173 - 182

Article Type: ORIGINAL ARTICLE

DOI:10.5301/jn.5000108

Authors

Biagio Di Iorio, Lucia Di Micco, Serena Torraca, Maria Luisa Sirico, Pasquale Guastaferro, Luigi Chiuchiolo, Filippo Nigro, Antonietta De Blasio, Paolo Romano, Andrea Pota, Roberto Rubino, Luigi Morrone, Teodoro Lopez, Francesco Gaetano Casino

Abstract

Background: Hemodialysis patients have a high cardiovascular mortality, and hypertension is the most prevalent treatable risk factor. We aimed to assess the predictive significance of dialysis-to-dialysis variability in blood pressure in hemodialysis patients. Methods: We performed a historical cohort study in 1,088 prevalent hemodialysis patients, followed up for 5 years. The risk of cardiovascular death was determined in relation to dialysis-to-dialysis variability in blood pressure, maximum blood pressure and pulse pressure. Results: Variability in blood pressure was a predictor of cardiovascular death (hazard ratio [HR] = 1.242; 95% confidence interval [95% CI], 1.004-1.537; p=0.046). Also age (HR=1.021; 95% CI, 1.011-1.048; p=0.049), diabetes (HR=1.134; 95% CI, 1.128-1.451; p=0.035), creatinine (HR=0.837; 95% CI, 0.717-0.977; p=0.024) and albumin (HR=0.901; 95% CI, 0.821-0.924; p=0.022) influenced mortality. Maximum blood pressure and pulse pressure did not show any effect on cardiovascular death. Conclusion: Dialysis-to-dialysis variability in blood pressure is a predictor of cardiovascular mortality in hemodialysis patients, and blood pressure variability may be used in managing hypertension and predicting outcomes in dialysis patients.

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