Interdialytic home systolic blood pressure variability increases all-cause mortality in hemodialysis patients

IF 2.4 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Clinical Cardiology Pub Date : 2024-03-29 DOI:10.1002/clc.24259

Liping Dong MD, Ming Tian MD, Hua Li MD, Junwu Dong MD, Xiaohong Song MD

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Abstract

Background

The association between Interdialytic home blood pressure variability (BPV) and the prognosis of patients undergoing maintenance hemodialysis (MHD) largely unknown.

Hypothesis

We proposed the hypothesis that interdialytic home BPV exert effect on cardiac and all-cause mortality among individuals undergoing MHD.

Methods

A total of 158 patients receiving MHD at the hemodialysis unit of Wuhan Fourth Hospital between December 2019 and August 2020 were included in this prospective cohort study. Patients were divided into tertiles according to the systolic BPV (SBPV), and the primary endpoints were cardiac and all-cause death. Kaplan–Meier analysis was used to assess the relationship between long-term survival and interdialytic home SBPV. In addition, Cox proportional hazards regression models were used to identify risk factors contributing to poor prognosis.

Results

The risk of cardiac death and all-cause death was gradually increased in patients according to tertiles of SBPV (3.5% vs. 14.8% vs. 19.2%, p for trend = .021; and 11.5% vs. 27.8% vs. 44.2%, p for trend <.001). The Cox regression analysis revealed that compared to Tertile 1, the hazard ratios for all-cause mortality in Tertile 2 and Tertile 3 were 3.13 (p = .026) and 3.24 (p = .021), respectively, after adjustment for a series of covariates.

Conclusions

The findings revealed a positive correlation between increased interdialytic home SBPV and elevated mortality risk in patients with MHD.

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透析间家庭收缩压变化会增加血液透析患者的全因死亡率。

背景：接受维持性血液透析（MHD）的患者在透析间期的家庭血压变异性（BPV）与预后之间的关系在很大程度上是未知的：我们提出的假设是，透析间期家庭血压变化对接受维持性血液透析（MHD）患者的心脏和全因死亡率有影响：本前瞻性队列研究纳入了 2019 年 12 月至 2020 年 8 月期间在武汉市第四医院血液透析室接受 MHD 治疗的 158 例患者。根据收缩压（SBPV）将患者分为三等分，主要终点为心脏死亡和全因死亡。Kaplan-Meier 分析用于评估长期生存与治疗间期家庭 SBPV 之间的关系。此外，还使用 Cox 比例危险回归模型来确定导致不良预后的风险因素：结果：患者心脏死亡和全因死亡的风险随 SBPV 的分层而逐渐增加（3.5% vs. 14.8% vs. 19.2%，p=0.021；11.5% vs. 27.8% vs. 44.2%，p=0.021）：研究结果表明，治疗间期家庭 SBPV 升高与 MHD 患者死亡风险升高呈正相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Cardiology 医学-心血管系统

CiteScore

5.10

自引率

3.70%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery. The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content. The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.