Abstract: SA-PO871
Long-Term Course of Peri-Dialytic Blood Pressures in Hemodialysis and Online Post-Dilution Hemodiafiltration Patients
Session Information
- Dialysis: Cardiovascular, BP, Volume
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Rootjes, Paul A., VU University Medical Center , Amsterdam, Netherlands
- de Roij van Zuijdewijn, Camiel LM, VU University Medical Center, Amsterdam, Netherlands
- Blankestijn, Peter J., University Medical Center----, Utrecht, Netherlands
- Canaud, Bernard J., FMC Deutschland GmbH, Bad Homburg, Germany
- Davenport, Andrew, Royal Free Hospital, London, United Kingdom
- van Ittersum, Frans J., VU University Medical Center Amsterdam, Amsterdam, Netherlands
- Grooteman, Muriel P., VU University Medical Center , Amsterdam, Netherlands
- Maduell, Francisco, Hospital Clinic Barcelona, Barcelona, Spain
- Nube, Menso, VU Medical Center, Bergen, Netherlands
Group or Team Name
- on behalf of the HDF Pooling Project Investigators
Background
Data on the course of blood pressure (BP) changes over time in dialysis patients is scarce. We investigated the long-term course of the pre-dialytical and post-dialytical (peri-dialytical) systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP) and pulse pressure (PP), as well as the difference between these values (delta) in patients from 3 randomized controlled trials comparing conventional hemodialysis (HD) with online post-dilution hemodiafiltration (HDF).
Methods
Individual participant data (IPD) were pooled from the Estudio de Supervivencia de Hemodiafiltración (ESHOL, n=906), the Dutch Convective Transport Study (CONTRAST, n=714) and the French HDF study (Frenchie, n=391). Due to censoring only 1613 (80%) of the included 2011 patients had complete follow-up. After additional data were obtained, 2006 (99,8%) were available for the present IPD meta-analysis (Peters SAE et al. Nephrol Dial Transplant 2016 31 978). BP measurements were available every three months. Two-years changes were assessed with linear mixed models.
Results
Mean pre-dialytic SBP decreased by 0.09 mmHg/month (P<0.001) and post-dialytic SBP by 0.07 mmHg/month (P=0.005). Mean pre-dialytic DBP decreased by 0.12 mmHg/month (P<0.001) and post-dialytic DBP by 0.13 mmHg/month (P<0.001). Mean pre-dialytic MAP decreased by 0.11mmHg/month (P<0.001) and post-dialytic MAP by 0.11 mmHg (P<0.001). Mean pre-dialytic PP increased by 0.02 mmHg/month (P=0.064) and post-dialytic PP increased by 0.06 mmHg/month (P=0.004). The mean delta SBP, DBP, MAP and PP did not change significantly over time. None of the above mentioned parameters differed significantly between HD and HDF patients.
Conclusion
This is the first report comparing the longitudinal course of the peri-dialytical SBP, DBP, MAP and PP between HD and HDF patients. While both pre- and post-dialysis mean SBP, DBP and MAP decreased significantly over time and PP increased, differences between HD and HDF patients were not observed.