[Blood pressure changes in chronically haemodialysed patients].

Area of Science:

• Nephrology
• Cardiovascular Medicine
• Clinical Hypertension

Context:

• Poorly controlled blood pressure (BP) in chronically haemodialysed patients significantly increases cardiovascular morbidity and mortality.
• Accurate BP monitoring during and after haemodialysis (HD) is crucial for effective treatment strategies.
• Ambulatory blood pressure monitoring (ABPM) provides valuable insights into BP fluctuations outside clinical settings.

Purpose:

• To assess BP variations during and for 24 hours post-haemodialysis using ABPM in patients with normal, high-normal, and hypertensive BP.
• To analyze the relationship between time-dependent BP changes, ultrafiltration (UF), and interdialytic weight gain (IDWG).

Summary:

• No significant intra-dialysis BP changes were observed. However, significant differences in post-dialysis BP were noted between groups (MAP < 100 mmHg vs. MAP ≥ 100 mmHg).
• Systolic BP decreased nocturnally in both groups, while diastolic BP decreased only in the hypertensive group. UF correlated with systolic BP changes in the normotensive group.
• IDWG did not demonstrate a significant influence on 24-hour BP, and no significant differences in non-dipper or reverse-dipper proportions were found between groups.

Impact:

• This study highlights the importance of ABPM for understanding 24-hour BP patterns in haemodialysis patients.
• Findings suggest tailored BP management strategies may be needed, considering pre-dialysis BP levels and nocturnal BP dipping patterns.
• The lack of correlation with IDWG emphasizes the need to explore other factors influencing BP variability in this population.