Pulse Pressure Determinants in Chronic Hemodialysis Patients

Abstract

Cardiovascular disease is the leading cause of morbidity and mortality in end-stage renal disease. Hypertension contributes to the high cardiovascular morbidity in patients undergoing chronic hemodialysis therapy (PCHD). Optimal blood pressure (BP) in dialysis patients is not different from recommendations for the general population. The definition of hypertension in patients undergoing chronic hemodialysis therapy is still under debate. Predialysis systolic and diastolic BP is of particular importance. The mean arterial pressure (MAP) also serves as an expression of BP in hemodialysis patients, instead of systolic or diastolic BP. Investigations in the general population have demonstrated the predictive utility of pulse pressure (systolic minus diastolic blood pressure), a measure reflecting the pulsatile nature of the cardiac cycle. Recent recognition of pulse pressure (PP) as an important correlate of mortality in patients receiving dialysis highlights the need to investigate the relationship between PP and clinical outcomes in patients with end-stage renal disease. We conducted this study to demonstrate clinical and biochemical determinants of predialysis and postdialysis PP values during a 15-month period in a group of patients undergoing chronic hemodialysis therapy.