Predialysis systolic blood pressure evolution in incident hemodialysis patients: effects of the dry weight method and prognostic value

Blood Purification
Charles ChazotGuillaume Jean

Abstract

The relationship between predialysis blood pressure (BP) and hemodialysis (HD) patient outcomes is controversial. We report the evolution of predialysis BP in incident patients treated with the dry weight method and its relationship with patients' outcomes. Between January 2000 and 2009, 308 patients started HD treatment. Fluid was progressively removed. The patients were encouraged to accept long-hour dialysis session and to follow a salt-restricted diet. BP and body weight (BW) were recorded and analyzed at start (week 1, W1) and weeks 8, 12, 26 and 52. The predialysis systolic BP decreased from 142.1 at W1 to 130.7 mm Hg at W52. Postdialysis BW decreased from W1 to W8 (-5.0 ± 4.5%). It was correlated with the decrease of the predialysis systolic BP at W26 and W52. Whereas the patient survival was significantly lower in the lower predialysis systolic BP tertile at W1 like in previous reports calling this phenomenon 'reverse epidemiology', no relationship between predialysis BP levels and outcomes was found at W12, W26 and W52. The patients in the tertile of the greater predialysis systolic BP decrease at W12 had significantly better survival in the whole group and in hypertensive patients. This relationship remained significa...Continue Reading

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Citations

Apr 19, 2013·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Charles ChazotMadhukar Misra
Jan 21, 2014·Seminars in Dialysis·Charles Chazot, Guillaume Jean
Jun 3, 2015·Clinical Kidney Journal·Natascha J H BroersJeroen P Kooman
Apr 23, 2014·Nephron. Clinical Practice·Charles ChazotGuillaume Jean
Oct 22, 2016·Seminars in Dialysis·James Tattersall
Jul 25, 2017·Cardiorenal Medicine·Charles ChazotGuillaume Jean
Nov 18, 2017·Hemodialysis International·Dugan W MadduxFranklin W Maddux
May 3, 2018·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Marijke DekkerJeroen Kooman
Mar 6, 2021·Nefrología : publicación oficial de la Sociedad Española Nefrologia·Raul Fernandez-PradoEmilio González-Parra

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