Comparison of Blood Pressure Control and Left Ventricular Hypertrophy in Patients on Continuous Ambulatory Peritoneal Dialysis (CAPD) and Automated Peritoneal Dialysis (APD)

Abstract

This study aimed to investigate the influence of different peritoneal dialysis regimens on blood pressure control, the diurnal pattern of blood pressure and left ventricular hypertrophy in patients on peritoneal dialysis. Forty-four patients undergoing peritoneal dialysis were enrolled into the study. Patients were treated with different regimens of peritoneal dialysis: 26 patients on continuous ambulatory peritoneal dialysis (CAPD) and 18 patients on automated peritoneal dialysis (APD). All patients performed 24-hour ambulatory blood pressure monitoring (ABPM) and echocardiography. Echocardiography was performed for measurement of cardiac parameters and calculation of left ventricular mass index (LVMI). There were no significant differences in average of systolic and diastolic blood pressure during 24-hour, daytime, and nighttime between CAPD and APD groups. There were no significant differences in diurnal variation of blood pressure, systolic and diastolic blood pressure load, and LVMI between CAPD and APD groups. LVMI was associated with 24 hour systolic blood pressure load (r = 0.311, P < 0.05) and daytime systolic blood pressure load (r = 0.360, P < 0.05). In conclusion, this study found that there is no difference in blood pressure control, diurnal variation of blood pressure and left ventricular hypertrophy between CAPD and APD patients. The different peritoneal dialysis regimens might not influence blood pressure control and diurnal variation of blood pressure in patients on peritoneal dialysis.

Left Ventricular Hypertrophy and Blood Pressure Control in Automated and Continuous Ambulatory Peritoneal Dialysis Patients

“…Also in PD patients, Jang et al. pointed out a significant association of LVMI with SBP load . In hemodialysis patients, Rahman et al.…”

“…In the presented study, the study participants were clinically euvolemic and the mean BP values obtained from 24-h ambulatory measurements were similar for patients on both treatment modalities. At this point, there are inconsistent reports in the literature; some authors reported no difference between APD and CAPD modalities (3,12,13), while some reported higher BP measurements in patients on APD therapy due to earlier loss of residual renal function and lesser…”

Cardiac, Inflammatory and Metabolic Parameters: Hemodialysis versus Peritoneal Dialysis

“…Hypertension and hypervolemia can result in an increase in the left ventricular (LV) afterload and may lead to an increase in LV wall thickness, although this condition alone fails to explain LV hypertrophy (LVH). Also, LVH is not always correlated with the severity of hypertension and hypervolemia in dialysis patients [3,12,13,14,15,16,17]. Another possible cause of LVH may be the increased cardiac output state produced by high-flow arteriovenous fistula, or anemia, as well as the direct effect of hyperparathyroidism [16,17].…”

The &quot;Pulse Time Index of Norm&quot; highly correlates with the left ventricular mass index in patients with arterial hypertension

“…Some studies support the usefulness of circadian BP rhythm (a dipping pattern, morning BP) in predicting organ damage 18,19. Other studies show the usefulness of the BP load in predicting organ damage 6,7,20. In this present study, we obtained a similar correlation between the BP load and the LVMI.…”

“…The PTIN calculation is similar to the principle of the BP load calculation. Several studies have shown that the mean 24-hour BP did not correlate with the left ventricular mass index (LVMI); however, an increased BP load was associated with a higher LVMI 6,7…”