Factors analysis on circadian rhythm of interdialytic blood pressure in maintenance hemodialysis patients / 中华肾脏病杂志

ABSTRACT

Objective To describe the circadian profiles of interdialytic blood pressure in maintenance hemodialysis patients and to investigate its related factors. Methods Ambulatory blood pressure monitoring (ABPM)was conducted in forty-four patients on regular hemodialysis during interdialytic days.Three groups were identified with their ambulatory blood pressurenon-hypertension group,controlled hypertension group and uncontrolled hypeaension group.Hemoglobin,creatinine,Kt/V,serum total calcium,serum phosphate,immunoreactive parathyroid hormone(iPTH),interdialytic weight gain and Morisky self-report scale etc.were assessed. Results (1)No significant difference was found in ABPM index ranged from decline in nocturnal systolic and diastolic blood pressure,AASI to dipper percentage in three groups.Nevertheless,24-h average pulse pressure in uncontrolled hypertension group was higher than the other groups[(80.06+13.41)vs(53.00±7.73),(57.85±21.97)mm Hg,all P＜0.01].(2)All the three groups showed the blood pressure profile of double-peak and trough.In the uncontrolled hypertension group,however,the nocturnal blood pressure decrease was not notable.(3)Nocturnal systolic blood pressure decline Was negatively correlated to iPTH(r=-0.039,P＜0.05).(4)In ten dippers out of all 44 patients,AASI was negatively correlated with nocturnal diastolic blood pressure decline (r=-0.748,P＜0.05). Conclusion Nocturnal blood pressure decline is correlated to iPTH and arterial selerosis.