The association of peritoneal transport properties with 24-hour blood pressure levels in CAPD patients.
OBJECTIVE
We aimed to investigate the effects of peritoneal transport characteristics on blood pressure (BP) parameters, measured by 24-hour ambulatory blood pressure monitoring (ABPM), and on the development of left ventricular hypertrophy (LVH) in continuous ambulatory peritoneal dialysis (CAPD) patients.


METHODS
Cross-sectional and prospective design.


METHODS
Tertiary-care center.


METHODS
25 CAPD patients (11 male, 14 female; mean age 47 +/- 14 years) were included. Mean time on CAPD was 22.9 +/- 18 months and all patients had been dialyzed for more than 6 months. The patients were divided into high, high-average, low-average, and low transport groups according to peritoneal equilibration test results.


METHODS
Daytime and nighttime systolic and diastolic BP and left ventricular mass index among the different peritoneal transport groups; changes in BP parameters before and after increase in ultrafiltration.


RESULTS
On 24-hour ABPM records, 13 patients (52%) were found to be hypertensive. Both mean systolic and diastolic BP were significantly increased in high-transporter groups compared to low transporters in both daytime and nighttime BP parameters. Left ventricular mass index was higher in high transporters compared to low transporters, without reaching statistical significance: 160 +/- 23 vs 119 +/- 41 g/m2, p > 0.05. Following increase in ultrafiltration, mean systolic (145 +/- 13 vs 128 +/- 5 mmHg, p < 0.001) and diastolic (96 +/- 10 vs 81 +/- 3 mmHg, p < 0.001) BP decreased, and BP levels returned to normotensive levels in 6 (46%) of the 13 hypertensive patients, requiring discontinuation of antihypertensive drugs.


CONCLUSIONS
Improvement in volume status resulted in a decrease in both daytime and nighttime BP. Differences in peritoneal transport properties were associated with the development of hypertension and LVH.
Tonbul
Zeki
Z
Division of Nephrology, Department of Internal Medicine, Selcuk University Medical School, Konya, Turkey.
Altintepe
Lutfullah
L
Sözlü
Cetin
C
Yeksan
Mehdi
M
Yildiz
Alaattin
A
Türk
Süleyman
S
D000328:Adult; D018660:Blood Pressure Monitoring, Ambulatory; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D010537:Peritoneum / Q000502:physiology / Q000503:physiopathology*; D011446:Prospective Studies; D016896:Treatment Outcome