title: Left ventricular hypertrophy and blood pressure control in automated and continuous ambulatory peritoneal dialysis patients.
abstract: Hypertension, non-dipper blood pressure (BP) pattern and decrease in daily urine output have been associated with left ventricular hypertrophy (LVH) in peritoneal dialysis (PD) patients. However, there is lack of data regarding the impact of different PD regimens on these factors. We aimed to investigate the impact of circadian rhythm of BP on LVH in end-stage renal disease patients using automated peritoneal dialysis (APD) or continuous ambulatory peritoneal dialysis (CAPD) modalities. Twenty APD (7 men, 13 women) and 28 CAPD (16 men, 12 women) patients were included into the study. 24-h ambulatory blood pressure monitoring (ABPM) and transthoracic echocardiography besides routine blood examinations were performed. Two groups were compared with each other for ABPM measurements, BP loads, dipping patterns, left ventricular mass index (LVMI) and daily urine output. Mean systolic and diastolic BP measurements, BP loads, LVMI, residual renal function (RRF) and percentage of non-dippers were found to be similar for the two groups. There were positive correlations of LVMI with BP measurements and BP loads. LVMI was found to be significantly higher in diastolic non-dippers compared to dippers (140.4 ± 35.3 vs 114.5 ± 29.7, respectively, P = 0.02). RRF and BP were found to be independent predictors of LVMI. Non-dipping BP pattern was a frequent finding among all PD patients without an inter-group difference. Additionally, higher BP measurements, decrease in daily urine output and non-dipper diastolic BP pattern were associated with LVMI. In order to avoid LVH, besides correction of anemia and volume control, circadian BP variability and diastolic dipping should also be taken into consideration in PD patients.
authors: Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors: Nuh
authors: N
authors: Ataş
authors: Yasemin
authors: Y
authors: Erten
authors: Gülay Ulusal
authors: GU
authors: Okyay
authors: Salih
authors: S
authors: Inal
authors: Salih
authors: S
authors: Topal
authors: Kürşad
authors: K
authors: Öneç
authors: Ahmet
authors: A
authors: Akyel
authors: Bülent
authors: B
authors: Çelik
authors: Yusuf
authors: Y
authors: Tavil
authors: Musa
authors: M
authors: Bali
authors: Turgay
authors: T
authors: Arınsoy
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm / Q000502:physiology; D004452:Echocardiography; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000379:methods*; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000379:methods; D014556:Urine / Q000502:physiology; D055815:Young Adult
keywords: Ambulatory blood pressure measurement; Left ventricular mass index; Non-dipper blood pressure pattern; Peritoneal dialysis