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Which dialysis unit blood pressure is the most accurate for predicting home blood pressure in patients undergoing hemodialysis?

  • Yoon, In-Cheol (Department of Internal Medicine, Myongji Hospital, Seonam University College of Medicine) ;
  • Choi, Hye-Min (Department of Internal Medicine, Myongji Hospital, Seonam University College of Medicine) ;
  • Oh, Dong-Jin (Department of Internal Medicine, Myongji Hospital, Seonam University College of Medicine)
  • Received : 2015.08.16
  • Accepted : 2015.10.03
  • Published : 2017.01.01

Abstract

Background/Aims: We investigated which dialysis unit blood pressure (BP) is the most useful for predicting home BP in patients undergoing hemodialysis (HD). Methods: Patients undergoing HD who had been treated > 3 months were included in this study. Exclusion criteria were hospitalized patients with acute illness and changes in dry weight and anti-hypertensive drugs 2 weeks before the study. We used the dialysis unit BP recording data, such as pre-HD, intra-HD, post-HD, mean pre-HD, and post-HD (pre-post-HD), mean pre-HD, intra-HD, and post-HD (pre-intra-post-HD) BP. Home BP (the same period of dialysis unit BP) was monitored as a reference method during 2 weeks using the same automatic oscillometric device. Patients were asked to record their BP three times daily (wake up, between noon and 6:00 PM, and at bedtime). Results: Significant differences were detected between home systolic blood pressure (SBP) and pre-HD, post-HD, and intra-HD SBP (p = 0.003, p = 0.001, p = 0.016, respectively). In contrast, no differences were observed between home SBP and pre-intra-post-HD and pre-post-HD SBP (p = 0.235, p = 0.307, respectively). Areas under the receiver operating characteristic curve for pre-intra-post-HD and pre-post-HD SBP with 2-week home BP as the reference standard were 0.812 and 0.801, respectively. Conclusions: These results suggest that pre-intra-post-HD and pre-post-HD SBP had similar accuracy for predicting mean 2-week home SBP in HD patients. Therefore, pre-intra-post-HD and pre-post-HD SBP should be useful for predicting home SBP in HD patients if ambulatory or home BP measurements are unavailable.

Keywords

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