title: Which dialysis unit blood pressure is the most accurate for predicting home blood pressure in patients undergoing hemodialysis?
abstract: OBJECTIVE
  We investigated which dialysis unit blood pressure (BP) is the most useful for predicting home BP in patients undergoing hemodialysis (HD).
  
  
  METHODS
  Patients undergoing HD who had been treated > 3 months were included in this study. Exclusion criteria were hospitalized patients with acute illness and changes in dry weight and anti-hypertensive drugs 2 weeks before the study. We used the dialysis unit BP recording data, such as pre-HD, intra-HD, post-HD, mean pre-HD, and post-HD (pre-post-HD), mean pre-HD, intra-HD, and post-HD (pre-intra-post-HD) BP. Home BP (the same period of dialysis unit BP) was monitored as a reference method during 2 weeks using the same automatic oscillometric device. Patients were asked to record their BP three times daily (wake up, between noon and 6:00 PM, and at bedtime).
  
  
  RESULTS
  Significant differences were detected between home systolic blood pressure (SBP) and pre-HD, post-HD, and intra-HD SBP (p= 0.003,p= 0.001,p= 0.016, respectively). In contrast, no differences were observed between home SBP and pre-intra-post-HD and pre-post-HD SBP (p= 0.235,p= 0.307, respectively). Areas under the receiver operating characteristic curve for pre-intra-post-HD and prepost-HD SBP with 2-week home BP as the reference standard were 0.812 and 0.801, respectively.
  
  
  CONCLUSIONS
  These results suggest that pre-intra-post-HD and pre-post-HD SBP had similar accuracy for predicting mean 2-week home SBP in HD patients. Therefore, pre-intra-post-HD and pre-post-HD SBP should be useful for predicting home SBP in HD patients if ambulatory or home BP measurements are unavailable.
authors.affiliation: Department of Internal Medicine, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea.
authors.forename: In-Cheol
authors.initials: IC
authors.lastname: Yoon
authors.affiliation: Department of Internal Medicine, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea.
authors.forename: Hye-Min
authors.initials: HM
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea.
authors.forename: Dong-Jin
authors.initials: DJ
authors.lastname: Oh
mesh_terms: D000368:Aged; D019540:Area Under Curve; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000503:physiopathology; D007674:Kidney Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D006435:Renal Dialysis / Q000009:adverse effects; D015203:Reproducibility of Results; D013599:Systole; D013997:Time Factors; D016896:Treatment Outcome
keywords: Blood pressure; Hemodialysis units, hospital; Home; Hypertension; Renal dialysis