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Blood pressure control in dialysis patients
open access
Abstract
Material and methods The retrospective analysis of 168 (mean age 62y) patients: 104 haemodialysis and 64 peritoneal dialysis patients was made based on the medical documentation. The medical history, BP measurements — before and after three HD sessions in HD group and twice a visit during three visits in PD group, body mass, residual diuresis, laboratory tests, the presence of peripheral edema and the echocardiography were taken. The kind of using hypotensive drugs and the connection between the number of them, the presence of volume overload, the presence of residual diuresis and BP control was analyzed.
Results HD patients were significantly older than PD group (Me = 64 v. Me = 57.5y, p < 0.05) and were treated with dialysis longer (Me = 33.6 v. Me = 27.5 mths, p < 0.05). There were no significant differences in the frequency of BP rates above ≥ 140/90 mm Hg. Diastolic BP was significantly lower in HD group (74.49 ± 12.57 v. 83.78 ± 12.15 mm Hg, p < 0.05). The residual diuresis was less present in HD group (44% v. 62%, p < 0.05). The median 24-hour urine collection value was 50 ml in HD group and 350 ml in PD group, p < 0.05. The peripheral edema was observed significantly more often in PD group with uncontrolled BP (above 140/90 mm Hg) (72.2% v. 35.7%, p < 0.05). The mean body mass gain between the HD sessions in HD group was 2 ± 2.1 kg. The average amount of hypotensive drugs was 2 in HD and 3 in PD patients. The most used hypotensive drug was betablocker. PD patients were treated with ACE-I and ARB significantly wider (p < 0.05). There were no differences in Echo parameters.
Conclusions There were a better BP and volume control in HD group. We affirmed the connection between BP control, volume status and the duration of dialysis, especially in PD patients. There should be the more aggressive salt dietary restriction and the better volume control in our PD patients and also ACE-I should be used more widely, particularly in patients with the high risk of cardiovascular disease.
Arterial Hypertension 2011, vol. 15, no 3, pages 169–176.
Abstract
Material and methods The retrospective analysis of 168 (mean age 62y) patients: 104 haemodialysis and 64 peritoneal dialysis patients was made based on the medical documentation. The medical history, BP measurements — before and after three HD sessions in HD group and twice a visit during three visits in PD group, body mass, residual diuresis, laboratory tests, the presence of peripheral edema and the echocardiography were taken. The kind of using hypotensive drugs and the connection between the number of them, the presence of volume overload, the presence of residual diuresis and BP control was analyzed.
Results HD patients were significantly older than PD group (Me = 64 v. Me = 57.5y, p < 0.05) and were treated with dialysis longer (Me = 33.6 v. Me = 27.5 mths, p < 0.05). There were no significant differences in the frequency of BP rates above ≥ 140/90 mm Hg. Diastolic BP was significantly lower in HD group (74.49 ± 12.57 v. 83.78 ± 12.15 mm Hg, p < 0.05). The residual diuresis was less present in HD group (44% v. 62%, p < 0.05). The median 24-hour urine collection value was 50 ml in HD group and 350 ml in PD group, p < 0.05. The peripheral edema was observed significantly more often in PD group with uncontrolled BP (above 140/90 mm Hg) (72.2% v. 35.7%, p < 0.05). The mean body mass gain between the HD sessions in HD group was 2 ± 2.1 kg. The average amount of hypotensive drugs was 2 in HD and 3 in PD patients. The most used hypotensive drug was betablocker. PD patients were treated with ACE-I and ARB significantly wider (p < 0.05). There were no differences in Echo parameters.
Conclusions There were a better BP and volume control in HD group. We affirmed the connection between BP control, volume status and the duration of dialysis, especially in PD patients. There should be the more aggressive salt dietary restriction and the better volume control in our PD patients and also ACE-I should be used more widely, particularly in patients with the high risk of cardiovascular disease.
Arterial Hypertension 2011, vol. 15, no 3, pages 169–176.
Keywords
chronic kidney disease; hypertension; haemodialysis; peritoneal dialysis
Title
Blood pressure control in dialysis patients
Journal
Issue
Article type
Original paper
Pages
169-176
Published online
2011-09-01
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1529
Article views/downloads
5420
Bibliographic record
Nadciśnienie tętnicze 2011;15(3):169-176.
Keywords
chronic kidney disease
hypertension
haemodialysis
peritoneal dialysis
Authors
Edyta Zbroch
Dominika Maciorkowska
Jolanta Małyszko
Michał Myśliwiec