Evidence for elevated pulse pressure in patients on chronic hemodialysis: a case-control study

Related Experiment Video

Updated: Sep 28, 2026

Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Masahiko Tozawa1, Kunitoshi Iseki, Chiho Iseki

  • 1Third Department of Internal Medicine, University of The Ryukyus, Okinawa, Japan. mtozawa@eb.mbn.or.jp

Kidney International
|November 13, 2002
PubMed

Insights

Hemodialysis patients exhibit significantly higher pulse pressure (PP) than healthy individuals, with elevated systolic blood pressure and lower diastolic blood pressure. Further research is needed to assess if managing this elevated PP improves patient outcomes.

Area of Science:

  • Nephrology
  • Cardiovascular Physiology
  • Clinical Research

Background:

  • Limited comparative data exists on pulse pressure (PP) between hemodialysis patients and healthy individuals.
  • This study retrospectively analyzed PP in a large cohort of hemodialysis patients versus matched controls.

Purpose of the Study:

  • To compare pulse pressure (PP) values in chronic hemodialysis patients and healthy control subjects.
  • To investigate the relationship between blood pressure components (SBP, DBP, PP) and mean arterial pressure (MAP) in these groups.

Main Methods:

  • Retrospective analysis of 234 chronic hemodialysis patients and 682 matched healthy control subjects.
  • Investigated relationships between systolic blood pressure (SBP), diastolic blood pressure (DBP), and PP with mean arterial pressure (MAP).
  • Subjects were matched for age, sex, diabetes mellitus, and body mass index.

Main Results:

  • Hemodialysis patients showed significantly higher PP than controls across all MAP levels (mean difference: 19.2 mm Hg).
  • Patients had higher SBP (mean difference: 12.8 mm Hg) and lower DBP (mean difference: 6.4 mm Hg) compared to controls at any given MAP.
  • Regression analyses indicated parallel relationships between PP and MAP, and between SBP/DBP and MAP, for both groups.

Conclusions:

  • Hemodialysis patients consistently present with higher SBP, lower DBP, and consequently, higher PP compared to healthy controls, even when matched for key demographics.
  • The clinical significance and potential benefits of reducing elevated PP in hemodialysis patients require further investigation.
Abstract

More Related Videos

Measurement of Tissue Oxygenation Using Near-Infrared Spectroscopy in Patients Undergoing Hemodialysis04:36

Measurement of Tissue Oxygenation Using Near-Infrared Spectroscopy in Patients Undergoing Hemodialysis

Published on: October 2, 2020

Related Concept Videos

Hypertension and Regulation of Blood Pressure01:18

Hypertension and Regulation of Blood Pressure

Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
Hemodialysis II: Procedure and Complications01:24

Hemodialysis II: Procedure and Complications

DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
Hemodialysis III: Nursing Management01:25

Hemodialysis III: Nursing Management

The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this measurement...
Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of fluid...
Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...