American Journal of Kidney Diseases
Volume 54, Issue 5 , Pages 881-890 , November 2009

Association of Blood Pressure Increases During Hemodialysis With 2-Year Mortality in Incident Hemodialysis Patients: A Secondary Analysis of the Dialysis Morbidity and Mortality Wave 2 Study

  • Jula K. Inrig, MD, MHS

      Affiliations

    • Department of Medicine, UT Southwestern Medical Center, Dallas, TX
    • Department of Medicine, Duke University Medical Center, Durham, NC
    • Corresponding Author InformationAddress correspondence to Jula K. Inrig, MD, MHS, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-8523
  • ,
  • Uptal D. Patel, MD

      Affiliations

    • Department of Medicine, Duke University Medical Center, Durham, NC
    • Duke Clinical Research Institute, Durham, NC
  • ,
  • Robert D. Toto, MD

      Affiliations

    • Department of Medicine, UT Southwestern Medical Center, Dallas, TX
  • ,
  • Lynda A. Szczech, MD, MSCE

      Affiliations

    • Department of Medicine, Duke University Medical Center, Durham, NC
    • Duke Clinical Research Institute, Durham, NC

Received 19 December 2008 ,Accepted 13 May 2009.

References 

  1. Shoji T, Tsubakihara Y, Fujii M, Imai E. Hemodialysis-associated hypotension as an independent risk factor for two-year mortality in hemodialysis patients. Kidney Int. 2004;66:1212–1220
  2. Chen J, Gul A, Sarnak MJ. Management of intradialytic hypertension: The ongoing challenge. Semin Dial. 2006;19:141–145
  3. Inrig JK, Oddone EZ, Hasselblad V, et al. Association of intradialytic blood pressure changes with hospitalization and mortality rates in prevalent ESRD patients. Kidney Int. 2007;71:454–461
  4. Chou KJ, Lee PT, Chen CL, et al. Physiological changes during hemodialysis in patients with intradialysis hypertension. Kidney Int. 2006;69:1833–1838
  5. Raj DS, Vincent B, Simpson K, et al. Hemodynamic changes during hemodialysis: Role of nitric oxide and endothelin. Kidney Int. 2002;61:697–704
  6. Koc M, Richards HB, Bihorac A, Ross EA, Schold JD, Segal MS. Circulating endothelial cells are associated with future vascular events in hemodialysis patients. Kidney Int. 2005;67:1078–1083
  7. Maruyama S, Taguchi A, Iwashima S, et al. Low circulating CD34(+) cell count is associated with poor prognosis in chronic hemodialysis patients. Kidney Int. 2008;74:1603–1609
  8. US Renal Data System. Researcher's Guide to the USRDS Database. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive Kidney Diseases; 2006;
  9. Inrig JK, Patel UD, Gillespie BS, et al. Relationship between interdialytic weight gain and blood pressure among prevalent hemodialysis patients. Am J Kidney Dis. 2007;50:108–118
  10. National Kidney Foundation. K/DOQI Clinical Practice Guidelines on Hypertension and Antihypertensive Agents in Chronic Kidney Disease. http://www.kidney.org/professionals/kdoqi/guidelinesAccessed February 10, 2007
  11. Jaar BG, Plantinga LC, Fink NE, et al. Comparison of Multiple Sources of Cause of Death in a Cohort of Incident Dialysis Patients: The CHOICE Study (ASN 40th Annual Conference SU-PO620). November 4, 2007;Philadelphia, PA
  12. Abbott KC, Trespalacios FC, Agodoa LY, Taylor AJ, Bakris GL. Beta-blocker use in long-term dialysis patients: Association with hospitalized heart failure and mortality. Arch Intern Med. 2004;164:2465–2471
  13. Klassen PS, Lowrie EG, Reddan DN, et al. Association between pulse pressure and mortality in patients undergoing maintenance hemodialysis. JAMA. 2002;287:1548–1555
  14. Agarwal R, Metiku T, Tegegne GG, et al. Diagnosing hypertension by intradialytic blood pressure recordings. Clin J Am Soc Nephrol. 2008;3:1364–1372
  15. Mendes RB, Santos SF, Dorigo D, et al. The use of peridialysis blood pressure and intradialytic blood pressure changes in the prediction of interdialytic blood pressure in haemodialysis patients. Blood Press Monit. 2003;8:243–248
  16. Heerspink HJ, Ninomiya T, Zoungas S, et al. Effect of lowering blood pressure on cardiovascular events and mortality in patients on dialysis: A systematic review and meta-analysis of randomised controlled trials. Lancet. 2009;373:1009–1015
  17. Agarwal R, Sinha AD. Cardiovascular protection with antihypertensive drugs in dialysis patients (Systematic review and meta-analysis). Hypertension. 2009;53:860–866
  18. Cirit M, Akcicek F, Terzioglu E, et al. Paradoxical rise in blood pressure during ultrafiltration in dialysis patients. Nephrol Dial Transplant. 1995;10:1417–1420
  19. Fishbane S, Natke E, Maesaka JK. Role of volume overload in dialysis-refractory hypertension. Am J Kidney Dis. 1996;28:257–261
  20. Gunal AI, Karaca I, Celiker H, Ilkay E, Duman S. Paradoxical rise in blood pressure during ultrafiltration is caused by increased cardiac output. J Nephrol. 2002;15:42–47
  21. Amabile N, Guerin AP, Leroyer A, et al. Circulating endothelial microparticles are associated with vascular dysfunction in patients with end-stage renal failure. J Am Soc Nephrol. 2005;16:3381–3388
  22. Werner N, Kosiol S, Schiegl T, et al. Circulating endothelial progenitor cells and cardiovascular outcomes. N Engl J Med. 2005;353:999–1007
  23. Agarwal R, Peixoto AJ, Santos SFF, Zoccali C. Pre- and postdialysis blood pressures are imprecise estimates of interdialytic ambulatory blood pressure. Clin J Am Soc Nephrol. 2006;1:389–398
  24. Agarwal R, Andersen MJ. Prognostic importance of ambulatory blood pressure recordings in patients with chronic kidney disease. Kidney Int. 2006;69:1175–1180

 Originally published online as doi: 10.1053/j.ajkd.2009.05.012 on July 31, 2009.

PII: S0272-6386(09)00836-1

doi: 10.1053/j.ajkd.2009.05.012

American Journal of Kidney Diseases
Volume 54, Issue 5 , Pages 881-890 , November 2009