Prognostic Value of Blood Pressure Responsiveness in Hemodialysis for Cardiovascular Mortality, Development of A New Predictive Equation

Authors

  • Sara Keshtkari 1Department of Internal Medicine, Aja University of Medical Sciences (AJAUMS), Tehran, Iran Author
  • Bahareh Hajibaratali Department of Cardiology, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Author
  • Mohammad Parsa Mahjoob Cardiovascular Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Author
  • Nooshin dalili Chronic Kidney Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Author
  • Shiva Samavat Chronic Kidney Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Author
  • Pedram Ahmadpoor Chronic Kidney Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Author
  • Sadra Ashrafi Student Research Committee, Chronic Kidney Disease Research Center (CKDRC), Shahid Beheshti University of Medical Siences, Tehran,Iran Author
  • Mostafa Shahrezaei Department of Orthopedic Surgery, Faculty of Medicine, AJA University of Medical Science, Tehran, Iran Author
  • Ali Reza Khoshdel Clinical Epidemiology Department, School of Medicine, AJA University of Medical Sciences, Tehran, Iran Author

Abstract

Introduction. Cardiovascular disease is considered as the main cause of mortality and morbidity in HD-patients and AS is a fundamental cause. This study was conducted to investigate whether intradialytic BP changes can use as a surrogate clinical marker. Methods. Fifty-one patients on maintenance hemodialysis, for at least 12 hours per week, were included in a prospective cohort study. Intradialytic BP was measured using validated automated device. PWV was performed to assess Augmentation Index (AIx) as marker of arterial stiffness. All measurements were repeated in alive individuals after 5 years of follow-up. Patients with 5% reduction of intradialytic BP were considered as HD-responsive and Several statistical analyses were employed based on responsiveness to HD. Results. After 5-year follow-up the findings demonstrated BP response to HD was an important and independent determinant of mortality (P < .05). Augmentation index (AIx) (P < .05), heart rate (P < .05), and calcium phosphate product (P < .05) as well as log PTH (P < .05) were significantly different between two responsive and non-responsive to HD. Pearson’s Correlation studies revealed a significant relationship between the BP response to HD and heart rate (r = 0.4, P < .05), LVEF (r = -0.4, P < .05) and PTH (r = -0.3, P < .05). BP response to HD and log-PTH remained significant even after age and gender adjustment (P < .05). Conclusion. BP-response to HD can use as a clinical and surrogate marker of AS which is significantly associated with mortality and LVEF. Arterial stiffness and intradialytic BP can predict the changes in Ejection Fraction (EF).

 

DOI: 10.52547/ijkd.6810

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Author Biography

  • Sara Keshtkari, 1Department of Internal Medicine, Aja University of Medical Sciences (AJAUMS), Tehran, Iran
    assisstant proffessor of nephrology , masih daneshvari hospital, SBMU

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Published

2021-12-20

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Section

ORIGINAL | Dialysis

How to Cite

Prognostic Value of Blood Pressure Responsiveness in Hemodialysis for Cardiovascular Mortality, Development of A New Predictive Equation. (2021). Iranian Journal of Kidney Diseases, 15(6), 441-450. https://ijkd.org/index.php/ijkd/article/view/6810

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