BLOOD PRESSURE MONITORING IN HEMODIALYSIS PATIENTS: ARE IMPRECISE THE MEASURING PRE- AND POSTDIALYSIS OR INTERDIALYTIC AMBULATORY BP?

Abstract

Objective: The optimal Blood Pressure in Hemodialysis are still unclear as to their value or measurement time and better hypotensive treatment. Some authors recommend BP < 140/90 mmHg and < 130/80 mmHg before and after HD respectively. There are an associations between predialysis systolic, diastolic and pulse pressure with all-cause mortality. Our objective is to assess the percentage of hypertensive patients in our hemodialysis unit after adjusting their dry weight and there is a difference between the pre and postdialysis blood pressure measurement. Design and method: We included 66 patients(N 66) hemodialysis unit, we have performed standardized BP measurements among hemodialysis patients, predialysis SBP/DBP, postdialysis SBP/DBP, pulse pressure and interdialytic BP assessed by ambulatory. Patients characteristics: (male [n 36] 54,5%), median age 68 yrs (R 29–90y), DM 25 patients (37,8%),nontraumatic amputation 10 patients (15%). Results: Predialysis SBP/DBP values >140/90 mmHg was 50% (33 patients), 51,5% female. Predialysis Pulse pressure 82 mmHg Postdialysis SBP/DBP values > 140/90 mmHg was 59% (39 patients), 54% female. Postdialysis Pulse pressure 83 mmHg Interdialytic BP value > 140/90 mmHg was 50% (30 patients) and Pulse pressure 78 mmHg Group HT:DM 17 patients(52%) nontraumatic amputation 8 patients(24%) Group NO HT:DM 8 patients(24%) nontraumatic amputation 2 patients(6%) (TABLE 1) Conclusions: Until the actuality there is no optimal criteria of BP in hemodialysis patients, or when it should be measured pre or postdialysis. In our study, we do not see a difference between BP Predialysis, Postdialysis or Interdialytic BP. Also we see in group HT, there are more diabetics and more nontrauamtic amputation but there is no significant difference between both groups, possibly for being a small sample