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Pulse Pressure Determinants in Chronic Hemodialysis Patients
Author(s) -
Kovacic V,
Sain M,
Dzanko D,
Vukman V
Publication year - 2003
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1046/j.1492-7535.2003.01220.x
Subject(s) - hemodialysis , medicine , blood pressure , hemoglobin , gastroenterology , erythropoietin , pulse pressure , stepwise regression , analysis of variance , parathyroid hormone , body mass index , ultrafiltration (renal) , urology , endocrinology , calcium , chemistry , chromatography
: Hypertension contributes to the cardiovascular morbidity in patients undergoing chronic hemodialysis therapy (PCHD). Pulse pressure (PP) was recognized as a correlate of mortality in PCHD. In order to demonstrate determinants of predialysis and postdialysis PP values in a group of PCHD, we conducted this study. Subjects and methods : Study subjects were 23 PCHD. Study time was 15 months. One hundred thirty six single hemodialysis (HD) treatments were processed. PP was computed as systolic‐diastolic blood pressure (mmHg). Statistical methods used were Student's t test for independent data, multivariate analysis of variance, Pearson's correlation, and forward stepwise multiple regression analysis. Results : Postdialysis and predialysis PPs differed significantly (65.51 ± 19.00 vs. 60.55 ± 19.35, p = 0.002). We did not find gender differences in PP before and after HD. PP before HD was in negative correlation with phosphorus concentration (r = − 0.244, p = 0.002), parathyroid hormone (PTH)(r = − 0.177, p = 0.020), hemoglobin (r = − 0.301, p < 0.001), single HD duration (r = − 0.162, p = 0.030), ultrafiltration rate per HD (r = − 0.290, p = 0.001), years on the chronic hemodialysis treatment (r = − 0.261, p = 0.001) and ultrafiltration volume/dry body mass ratio (UF/W)(r = − 0.222, p = 0.005) and in positive concentration with weekly erythropoietin (r = 0.391, p < 001) and age (r = 0.285, p < 0.001). PP after HD was in significant negative correlation with phosphorus concentration (r = − 0.205, p = 0.009), PTH (r = − 0.187, p = 0.015), hemoglobin (r = − 0.238, p = 0.005), ultrafiltration per HD (r = − 0.370, p < 0.001), dry body mass index (r = − 0.225, p = 0.003), years of the chronic hemodialysis treatment (r = 0.330, p < 0.001), UF/W (r = − 0.340, p < 0.001) and in positive concentration with weekly erythropoietin (r = 0.361, p < 0.001) and age (r = 0.227, p = 0.004). Multiple regression analyses unveiled the strongest and negative correlations between PP after HD and UF/W ratio (β = − 0.41, p < 0.001). The strongest, but positive correlation was found between PP before HD and erythropoietin per week (β = 0.51, p < 0.001). Conclusion : Determinants of the pre/post PP values are similar. Ultrafiltration is a strong predictor of postdialysis PP value.