Nephrology Dialysis Transplantation, Vol 12, Issue 11 2308-2311, Copyright © 1997 by Oxford University Press
T Savage, F Fabbian, M Giles, C Tomson and A Raine
Background: Hypertension, which is often associated
with hypervolaemia is common in haemodialysis patients and is a known
determinant of target organ damage. Interdialytic weight gain due to volume
overload has also been associated with mortality in haemodialysis patients.
Methods: We therefore studied 27 chronic haemodialysis
patients who underwent 48-h ambulatory blood pressure monitoring between
two midweek dialysis sessions, and 2D and M-mode echocardiography for
determination of left ventricular mass index. Results:
Left ventricular hypertrophy (left ventricular mass index in men
>131 g/m2, women >100
g/m2) was present in 70% (19/27) patients despite a
mean 48-h blood pressure of 132±19/81±15 mmHg. Mean
interdialytic weight gain was 1.6±0.8 kg and was not related to
left ventricular mass index. Two patterns of interdialytic blood pressure
change were apparent: in group 1 (16 patients) 48-h blood pressure
increased (+19±12/13±9 mmHg), whereas in group 2 (11
patients) blood pressure fell (-10±13/-8±10 mmHg P
<0.0001). In both groups the number of hypertensive patients (group
1, 10/16; group 2, 6/11), the 48-h blood pressure
(132±20/80±15 vs 132±18/82±15
mmHg and interdialytic weight gain (+1.9±0.7 vs
+1.3±0.7 kg) were similar. There was also no correlation between
interdialytic blood pressure change and weight gain in either group.
Conclusions: We conclude that interdialytic blood
pressure changes cannot be directly related to interdialytic fluid gain,
even in apparent volume-dependent hypertension, emphasizing the importance
of additional factors in the control of blood pressure in end-stage renal
disease. Key words: haemodialysis; interdialytic
weight gain; blood pressure; left ventricular hypertrophy
ORIGINAL ARTICLES
Interdialytic weight gain and 48-h blood pressure in haemodialysis patients
Anthony Raine Laboratories and Department of Cardiology, St Bartholomew's Hospital, London, UK; Department of Nephrology, Southmead Hospital, Bristol, UK; Arcispedale S Anna, Ferrara, Italy
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