Ultrafiltration volume is associated with changes in blood pressure in chronically hemodialyzed patients.
BACKGROUND
Volume overload is a main factor in development of hypertension in hemodialysis patients. In order to demonstrate impact of ultrafiltration volume on blood pressure during 15-months period in a group of patients undergoing chronic hemodialysis therapy, we conducted this study. We hypothesized that ultrafiltration volume different affects the pre/postdialysis systolic pressure, diastolic pressure, mean arterial pressure (MAP), and pulse pressure (PP) values.


METHODS
Study subjects were 23 anuric chronically hemodialyzed patients. The overall study time was 15 months, and 136 single hemodialysis treatments were analyzed.


RESULTS
Ultrafiltration was negatively correlated with predialysis systolic blood pressure (r = -0.169, p = 0.025), postdialysis systolic blood pressure (r = -0.292, p < 0.001), postdialysis MAP (r = -0.186, p = 0.015), predialysis PP (r = -0.290, p < 0.001), and postdialysis PP (r = -0.370, p < 0.001). Ultrafiltration/dry body mass (UF/W) ratio was negatively correlated with predialysis PP (r = -0.222, p = 0.005), postdialysis PP (r = -0.340, p < 0.001), and postdialysis systolic blood pressure (r = -0.243, p = 0.002). We found significant difference in postdialysis PP between dialyses with UF/W ratio < or = 0.05 an dialyses with UF/W ratio > 0.05 (63.49 +/- 20.76 vs. 56.27 +/- 16.33 mmHg, p = 0.033).


CONCLUSIONS
The ultrafiltration volume strongly affects postdialysis PP values. Evaluation of elevated blood pressure treatment in patients undergoing chronic hemodialysis therapy must be considered in respect of postdialysis PP values, not just depending on pre/postdialysis systolic and diastolic pressur or MAP values.
Kovacic
Vedran
V
Hemodialysis Department, Medical Center Trogir, Trogir, Croatia. vedkovac@inet.hr
Roguljic
Luka
L
Kovacic
Vinko
V
Bacic
Boris
B
Bosnjak
Tamara
T
D000368:Aged; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015312:Hemodialysis Solutions / Q000378:metabolism / Q000494:pharmacology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology*; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000628:therapy*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D011336:Probability; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods*; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014462:Ultrafiltration / Q000009:adverse effects*
D015312:Hemodialysis Solutions