BP PHENOTYPES IN PATIENTS UNDERGOING LONG-TERM PERITONEAL DIALYSIS DEFINED WITH HOME VERSUS AMBULATORY BP MONITORING

Abstract

Objective: The concomitant assessment of office with out-of-office blood pressure (BP) measurements enables the identification of white-coat and masked hypertension. The aim of the present study was to explore the prevalence of these BP phenotypes in end-stage kidney disease patients undergoing peritoneal dialysis (PD) with the use of home versus ambulatory BP monitoring. Design and method: In 140 patients receiving long-term PD in 4 centers of Northern Greece, we assessed the BP with the following methods: (i) triplicate office BP measurements after a 5-minute seated rest with the automatic device HEM 705-CP (Omron, HealthCare); (ii) home BP measurements twice daily for 7 consecutive days with validated BP monitors; (iii) 24-hour ambulatory BP monitoring with the oscillometric device Mobil-O-Graph (IEM, Stolberg, Germany). The BP phenotypes were diagnosed using the threshold of 140/90 mmHg for office measurements and the threshold of 135/85 mmHg for home and daytime ambulatory BP recordings, respectively. Results: When office BP recordings were assessed together with home BP measurements, 57 patients (40.7%) were classified as normotensives, 8 patients (5.7%) had white-coat hypertension, 21 patients (15.0%) had masked hypertension and the remaining 54 patients (38.6%) had sustained hypertension. With the evaluation of office and daytime ambulatory BP, 59 patients (42.1%) had normotension, 13 patients (9.1%) had white-coat hypertension, 19 patients (13.6%) had masked hypertension and 49 patients (35.0%) had sustained hypertension. In 119 out of 140 patients (85.0%), there was absolute agreement between home and daytime ambulatory BP in the diagnosis of BP phenotype (k-coefficient: 0.775, P<0.001). Conclusions: The present study shows that among patients undergoing PD, there is satisfactory agreement between home and daytime ambulatory BP in the identification of phenotypes of white-coat and masked hypertension.