Impact of Hemocontrol on Hypertension, Nursing Interventions, and Quality of Life

Déziel, Clement; Bouchard, Josée; Zellweger, Michael J.; Madore, François

doi:10.2215/cjn.04171206

Cited by 36 publications

(23 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These findings indicate that home BP monitoring per se could help improve BP control in the hemodialysis population. Another 6-month randomized, controlled trial tested the notion that the automatic feedback system of dialysis will improve hypertension control compared with standard dialysis [29]. A systematic BP management protocol was used in addition to the automatic feedback system dialysis or standard dialysis in all patients.…”

Section: Discussionmentioning

confidence: 99%

Home Blood Pressure Measurements for Managing Hypertension in Hemodialysis Patients

et al. 2009

View full text Add to dashboard Cite

Home blood pressure (BP) monitoring serves as a practical method to detect changes in BP instead of ambulatory BP monitoring in hemodialysis patients. To evaluate the relationship of reduction in home BP compared to interdialytic ambulatory BP measurements we analyzed the data from the dry-weight reduction in hypertensive hemodialysis patients (DRIP) trial in which 100 patients had their dry weight probed based on clinical sign and symptoms and 50 patients served as controls. We measured home BP 3 times a day for 1 week using a validated oscillometric monitor on 3 occasions at 4-week intervals after randomization. Changes from baseline in home, predialysis BP and postdialysis BP were compared to interdialytic 44-hour ambulatory BP. Home and ambulatory BP monitoring was available in 141 of 150 (94%) patients. Predialysis systolic BP was not as sensitive as ambulatory BP in detecting change in BP with dry-weight reduction. Whereas postdialysis BP was capable of detecting an improvement in systolic BP in response to probing dry weight, by itself it does not provide evidence that change in postdialysis BP persists over the interdialytic period. Home BP reliably detected changes in ambulatory BP, albeit with less sensitivity at 4 weeks. However, at 4 and at 8 weeks, changes in home systolic BP were most strongly related to changes in interdialytic ambulatory systolic BP compared to predialysis and postdialysis BP. The reproducibility of BP measurements followed the order home > ambulatory >> predialysis > postdialysis. These data provide support for the use of home BP monitoring for the management of hypertension in hemodialysis patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Home Blood Pressure Measurements for Managing Hypertension in Hemodialysis Patients

et al. 2009

View full text Add to dashboard Cite

show abstract

“…Home BP readings are more reproducible from 1 week to the next when compared to pre or post-dialysis BP readings [37]. Home BP is recommended as a guide to the management of BP in dialysis patients and is useful to track changes in BP induced by reducing estimated dry-weight [37,38]. Studies have shown that HBPM is superior when compared to pre-dialysis BP readings to manage antihypertensive therapy adjustments [39] and improves BP control [40].…”

Section: Hbpm In Ckdmentioning

confidence: 99%

Central BP Monitoring, Home BP Monitoring, Ambulatory BP Monitoring in CKD

Cohen

Huan

Townsend

2014

Chronic Kidney Disease and Hypertension

View full text Add to dashboard Cite

Hypertension is common among patients with chronic kidney disease (CKD) and the prevalence of hypertension increases as overall kidney function deteriorates, ranging from 60 to 100 % depending on the population studied [1]. This chapter will specifically discuss the role of central blood pressure (BP) monitoring, home BP monitoring (HBPM), and ambulatory BP monitoring (ABPM) in the CKD population. Central BP Monitoring in CKDFor over a century, the gold standard for BP measurement has been the peripheral brachial BP by conventional sphygmomanometry. Despite being a traditional predictor of cardiovascular (CV) risk [2], peripheral brachial BP does not accurately represent central aortic pressure which is intuitively more relevant to the true BP burden experienced by the major organs. While the mean and diastolic BP remain mostly unchanged, the systolic BP and pulse pressure (the difference between the systolic and diastolic BP) are amplified from the aortic root to the peripheral brachial artery. Central aortic BP and arterial compliance can now be reliably assessed using noninvasive applanation tonometry [3] and the reproducibility of these measurements has been confirmed in the CKD population [4][5][6]. Emerging data suggest that measurements of central aortic BP and arterial compliance may be more robust

show abstract

“…The authors concluded that the higher post HD systolic BP may explain the improvement of inter-HD symptoms observed in other studies (see below), although their study did not specifically evaluate interdialytic symptoms. Only one randomized controlled trial did not restrict patient selection on the basis of previous hemodynamic instability or fluid overload (Déziel et al 2007). This study included 57 patients (55% of them hypotension-prone) who were randomized to either standard HD or Hemocontrol®-driven HD.…”

Section: Reduction Of Intradialytic Hypotension and Nursing Interventmentioning

confidence: 99%

“…In addition, Santoro et al (2002) also showed a 10% decrease of interdialytic symptoms following treatment with BV-controlled HD. In a study by Déziel et al (2007), the Kidney Disease and Quality of Life questionnaire (KDQOL) was used to evaluate quality of life at baseline and after 6 months of treatment with either Hemocontrol® or standard HD. Among the 20 items related to physical and mental health, only one parameter, burden of kidney disease, was significantly improved in the Hemocontrol® group versus the control group.…”

Section: Reduction Of Intra-and Inter-dialytic Symptoms and Improvemementioning

confidence: 99%

“…At 6 months, there was no statistically significant difference between the two groups in the primary endpoint (change in ECFV) nor were there any significant differences in systolic blood pressure, total UF and interdialytic weight gain. Finally, in a trial by Déziel et al (2007), change in home blood pressure was evaluated following treatment with BV device versus standard HD. Patients were not selected on the basis of prior hypertension or volume overload history.…”

Section: Hypertension and Volume Controlmentioning

confidence: 99%

See 1 more Smart Citation