Association Between Residual Kidney Function and Visit-to-Visit Blood Pressure Variability in Peritoneal Dialysis...

Visit-to-visit blood pressure (BP) variability has recently been recognized as an important risk factor for decline of residual kidney function (RKF) in patients with chronic kidney disease. However little is known about the impact of visit-to-visit BP variability on RKF in peritoneal dialysis (PD) patients. We retrospectively studied the association between RKF and visit-to-visit BP variability in 42 patients who started on PD between February 2006 and March 2012. Residual kidney function was defined as the mean of the urea and creatinine clearances in the patients. Visit-to-visit BP variability was defined as the average real variability of BP measurements taken during 12 consecutive visits after the start of PD. A significant association between the slope of RKF after the start of PD and the visit-to-visit variability of systolic BP was evident (r = -0.353, p = 0.022). On multiple regression analysis, the association was significant (p = 0.024) after adjustments for possible confounders (proteinuria, estimated glomerular filtration rate, and mean systolic BP). Decline in RKF was significantly associated with visit-to-visit BP variability in PD patients. The results suggest that RKF can be better maintained by reducing visit-to-visit BP variability.