Which dialysis unit blood pressure is the most accurate for predicting home blood pressure in patients undergoing hemodialysis?

Abstract

Background/AimsWe investigated which dialysis unit blood pressure (BP) is the most useful for predicting home BP in patients undergoing hemodialysis (HD).MethodsPatients undergoing HD who had been treated > 3 months were included in this study. Exclusion criteria were hospitalized patients with acute illness and changes in dry weight and anti-hypertensive drugs 2 weeks before the study. We used the dialysis unit BP recording data, such as pre-HD, intra-HD, post-HD, mean pre-HD, and post-HD (pre-post-HD), mean pre-HD, intra-HD, and post-HD (pre-intra-post-HD) BP. Home BP (the same period of dialysis unit BP) was monitored as a reference method during 2 weeks using the same automatic oscillometric device. Patients were asked to record their BP three times daily (wake up, between noon and 6:00 PM, and at bedtime).ResultsSignificant differences were detected between home systolic blood pressure (SBP) and pre-HD, post-HD, and intra-HD SBP (p = 0.003, p = 0.001, p = 0.016, respectively). In contrast, no differences were observed between home SBP and pre-intra-post-HD and pre-post-HD SBP (p = 0.235, p = 0.307, respectively). Areas under the receiver operating characteristic curve for pre-intra-post-HD and prepost-HD SBP with 2-week home BP as the reference standard were 0.812 and 0.801, respectively.ConclusionsThese results suggest that pre-intra-post-HD and pre-post-HD SBP had similar accuracy for predicting mean 2-week home SBP in HD patients. Therefore, pre-intra-post-HD and pre-post-HD SBP should be useful for predicting home SBP in HD patients if ambulatory or home BP measurements are unavailable.

Pharmacist counseling is an important factor in lowering blood pressure of hemodialysis patients with hypertension

“…Continuous monitoring and pharmacist counseling will support the plan of care for those kinds of patients as those services can prevent medication errors and improve patient's adherence as well as discover patient's problems related to medications 7 Even though some studies indicate ambulatory and home blood pressure monitoring have superior benefits as guidance for hypertension diagnosis, prognosis, and management in hemodialysis patients 8,9 , yet it can't be applicated in Indonesia whose majority of the patients neither having personal blood pressure monitor nor understanding how to use it. A study has shown that mean of pre-intra-post dialysis systolic blood pressure is not significantly different from that routine measured at home 10 . Other than that, hemodialysis unit blood pressure measurement is the routine procedure during hemodialysis session.…”

Dialysis unit blood pressure two hours after hemodialysis is useful for predicting home blood pressure and ambulatory blood pressure in maintenance hemodialysis patients

“…Previous studies showed how to measure BP correctly in HD patients; however, there is no established method yet [8,9]. In a previous Korean study, the authors suggested that averages of systolic blood pressure (SBP) measured pre‐, intra‐, and post‐dialysis might be useful for predicting home SBP in HD patients [10]. Agarwal et al [11] suggested that averaging multiple BP values, using 20‐min postdialysis readings or home BP monitoring can improve HD patients' BP determinations.…”