Blood Pressure Measurement and Left Ventricular Mass Index in Hemodialysis Patients: Comparison of Several Methods

Authors

  • Amir Ahmad Nassiri Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Legha Lotfollahi Division of Nephrology, Department of Medicine, Hasheminejad Kidney Center, Iran University of Medical Sciences; National research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences; Tehran, Iran
  • Neda Behzadnia Cardiology Department, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Ilad Alavi Darazam Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Monir Sadat Hakemi Department of Internal Medicine and Nephrology, Dr Shariati Hospital. Tehran University of Medical Sciences, Tehran, Iran
  • Azam Rahimzadeh Kalaleh National research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences; Tehran, Iran
  • Monir Kamalkhani National research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences; Tehran, Iran

Abstract

Introduction. Systemic arterial hypertension is prevalent in end-stage renal disease and is closely associated with left ventricular hypertrophy (LVH). Blood pressure (BP) behavior is unique in this population, and it is not clear which BP measurement should be used for treatment guidance. We aimed to evaluate the association of several methods of BP measurement with left ventricular mass index (LVMI) as hypertensive end-organ damage.

Materials and Methods. Patients on maintenance hemodialysis, 3 or 4 times per week for at least 3 months, were enrolled. We compared the diagnostic value of 6 different methods of BP measurement, including predialysis, postdialysis, interdialysis, and standard BP measurements as well as ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring, based on LVMI as the gold standard.

Results. Twenty patients, including 9 women and 11 men were enrolled. Ten patients (50%) had LVH and the others had normal LVMI (LVMI > 100 g/m2 for women and > 131 100 g/m2 for men). Only predialysis and postdialysis systolic BP values were significantly associated with LVMI (P = .02 and P = .02, respectively).

Conclusions. Predialysis and postdialysis systolic BP values maybe reliable for detecting hypertension in hemodialysis patients, although according to previous data, the importance of self and ambulatory BP monitoring could not be overlooked. 

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Published

2018-06-07

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Section

ORIGINAL | Dialysis