Correlation Analysis of Blood Pressure Variability, Crystalloid Osmotic Pressure, and Cardiovascular Events in Maintenance Hemodialysis Patients
DOI:
https://doi.org/10.52547/yjd0ws27Keywords:
Hemodialysis, Blood pressure, Osmotic pressure, Cardiovascular diseasesAbstract
Introduction. This study aimed to analyze the correlation between blood pressure variability (BPV), crystalloid osmotic pressure, and cardiovascular events (CEs) in patients undergoing maintenance hemodialysis (MHD).
Methods. This retrospective analysis was conducted on 71 patients with end-stage kidney disease who underwent hemodialysis at Beilun District People’s Hospital from September 2021 to September 2022. The patients were divided into two groups based on the occurrence of CEs: a cardiovascular event group and a non-cardiovascular event group.
Results. The 71 patients were divided into two groups based on the occurrence of CEs: the CEs group (25 patients who experienced CEs) and the non-CEs group (46 patients who did not experience CEs). The CEs group had significantly higher levels of crystalloid osmotic pressure, standard deviation of systolic BP (SBP-SD), coefficient of variation of SBP (SBP-CV), SD of diastolic BP (DBP-SD), and DBP-CV (P < .05). Multivariate logistic regression analysis identified crystalloid osmotic pressure, SBP-CV, and DBP-CV as independent risk factors for CEs. The ROC curve analysis indicated that the combined predictive value of crystalloid osmotic pressure, SBP-CV, and DBP-CV was significant, with an area under the curve (AUC) of 0.963.
Conclusion. Elevated crystalloid osmotic pressure, SBP-CV, and DBP-CV are critical risk factors with strong predictive value for predicting CEs in MHD patients
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References
1. Verdecc hia P, Borgioni C, Ciucci A, et al. Prognostic significance of blood pressure variability in essential hypertension. Blood Press Monit. 1996; 1(1): 3-11.
2. Raimann JG, Tzamaloukas AH, Levin NW, et al. Osmotic Pressure in Clinical Medicine with an Emphasis on Dialysis. Semin Dialysis. 2017; 30(1): 69-79.
3. Raimann JG, Tzamaloukas AH, Levin NW, Ing TS. Osmotic Pressure in Clinical Medicine with an Emphasis on Dialysis. Semin Dial. 2017 Jan;30(1):69-79.
4. Vaios V , Georgianos PI, Liakopoulos V, et al. Assessment and Management of Hypertension among Patients on Peritoneal Dialysis. Clin J Am Soc Nephro. 2019; 14(2): 297-305.
5. Stern A, Sachdeva S, Kapoor R, et al. High blood pressure in dialysis patients: cause, pathophysiology, influence on morbidity, mortality and management. J Clin Diagn Res. 2014; 8(6): ME01-ME04.
6. Lin BY, Li P, Wu XD, et al. The Relationship Between Homocysteine, Blood Pressure Variability, and Left Ventricular Hypertrophy in Patients with Essential Hypertension: An Observational Study. Adv Ther. 2020;
37(1): 381-389.
7. Pringle E, Phillips C, Thijs L, et al. Systolic blood pressure variability as a risk factor for stroke and cardiovascular mortality in the elderly hypertensive population. J Hypertens. 2003; 21(12): 2251-2257.
8. Suchy-Dicey AM, Wallace ER, Mitchell SV, et al. Blood pressure variability and the risk of all-cause mortality, incident myocardial infarction, and incident stroke in the cardiovascular health study. Am J Hypertens. 2013; 26(10): 1210-1217.
9. Heavens KR, Kenefick RW, Caruso EM, et al. Validation of equations used to predict plasma osmolality in a healthy adult cohort. Am J Clin Nutr. 2014; 100(5): 1252-1256.
10. Rothwell PM, Howard SC, Dolan E, et al. Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension. Lancet. 2010; 375(9718): 895-905.
11. Shafi T, Sozio SM, Bandeen-Roche KJ, et al. Predialysis systolic BP variability and outcomes in hemodialysis patients. J Am Soc Nephrol. 2014; 25(4): 799-809.
12. Cheng Y, Zhang F, Zhu J, et al. Influence of blood pressure variability on the life of arteriovenous fistulae in maintenance hemodialysis patients. Clin Hemorheol Micro. 2016; 62(2): 129-137.
13. Yamamoto K, Kobayashi N, Kutsuna T, et al. Excessive fall of blood pressure during maintenance hemodialysis in patients with chronic renal failure is induced by vascular malfunction and imbalance of autonomic nervous activity. Ther Apher Dial. 2012; 16(3): 219-225.
14. Chang TI, Flythe JE, Brunelli SM, et al. Visit-to-visit systolic blood pressure variability and outcomes in hemodialysis. J Hum Hypertens. 2014; 28(1): 18-24.
15. Da J, Zhang Z, Shen Y, et al. Blood pressure variability is independent of systolic pressure in adolescent and young adult patients undergoing hemodialysis. Pediatr Res. 2018; 83(3): 615-621.
16. Karpetas A, Loutradis C, Bikos A, et al. Blood pressure variability is increasing from the first to the second day of the interdialytic interval in hemodialysis patients. J Hypertens. 2017; 35(12): 2517-2526.
17. Preciado P, Zhang H, Thijssen S, et al. All-cause mortality in relation to changes in relative blood volume during
hemodialysis. Nephrol Dial Transpl. 2019; 34(8): 1401-1408.
18. Sander D, Kukla C, Klingelhofer J, et al. Relationship between circadian blood pressure patterns and progression of early carotid atherosclerosis: A 3-year follow-up study. Circulation. 2000; 102(13): 1536-1541.
19. Tatasciore A, Renda G, Zimarino M, et al. Awake systolic blood pressure variability correlates with target-organ damage in hypertensive subjects. Hypertension. 2007; 50(2): 325-332.
