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Interdialytic weight gain, compliance with dialysis regimen, and age are independent predictors of blood pressure in hemodialysis patients.

Abstract

Hypertension is a common problem in patients undergoing chronic hemodialysis. The purpose of this study is to identify the clinical and demographic factors independently associated with blood pressure in this population. Data collected for the Dialysis Morbidity and Mortality Study Wave 1 by the US Renal Data System were analyzed. The mean predialysis blood pressure for this cohort of 5,369 patients was 149/79 mm Hg. Sixty-three percent of the patients were hypertensive; 27%, 25%, and 11% had stages 1, 2, and 3 hypertension, respectively. Young age, black race, male sex, diabetes as cause of end-stage renal disease, erythropoietin therapy, and smoking were associated with higher blood pressure in the univariate analysis. Patients skipping or shortening one or more dialysis treatments had higher blood pressure. The presence of congestive heart failure and coronary heart disease was associated with lower blood pressure. On multivariate analysis, high interdialytic weight gain, noncompliance with dialysis regimen, and younger age were independent predictors of higher blood pressure. In summary, hypertension is common and poorly controlled in patients undergoing chronic hemodialysis. Greater interdialytic weight gain and noncompliance with dialysis regimen are independently associated with higher blood pressure, and advancing age is associated with lower blood pressure levels in this population. Therapeutic regimens emphasizing reduction of interdialytic weight gain and improved compliance with the dialysis regimen need to be evaluated for improving the management of hypertension. The effect of age and other comorbid conditions, particularly cardiovascular disease, must be considered while studying the relationship between blood pressure and mortality in patients undergoing chronic hemodialysis.

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  • Publisher Full Text

    • Grapherence [↓16]

    Authors+Show Affiliations

    Rahman M
    ,

    Department of Medicine, Case Western Reserve University/University Hospitals of Cleveland, OH 44106, USA. mxr9@po.cwru.edu

    Fu P
    ,
    Sehgal AR
    ,
    Smith MC

    Source

    MeSH

    Age Factors
    Female
    Humans
    Hypertension
    Male
    Middle Aged
    Multivariate Analysis
    Patient Compliance
    Renal Dialysis
    Weight Gain

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    10676725

    Citation

    Rahman, M, et al. "Interdialytic Weight Gain, Compliance With Dialysis Regimen, and Age Are Independent Predictors of Blood Pressure in Hemodialysis Patients." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 35, no. 2, 2000, pp. 257-65.
    Rahman M, Fu P, Sehgal AR, et al. Interdialytic weight gain, compliance with dialysis regimen, and age are independent predictors of blood pressure in hemodialysis patients. Am J Kidney Dis. 2000;35(2):257-65.
    Rahman, M., Fu, P., Sehgal, A. R., & Smith, M. C. (2000). Interdialytic weight gain, compliance with dialysis regimen, and age are independent predictors of blood pressure in hemodialysis patients. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 35(2), pp. 257-65.
    Rahman M, et al. Interdialytic Weight Gain, Compliance With Dialysis Regimen, and Age Are Independent Predictors of Blood Pressure in Hemodialysis Patients. Am J Kidney Dis. 2000;35(2):257-65. PubMed PMID: 10676725.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Interdialytic weight gain, compliance with dialysis regimen, and age are independent predictors of blood pressure in hemodialysis patients. AU - Rahman,M, AU - Fu,P, AU - Sehgal,A R, AU - Smith,M C, PY - 2000/2/17/pubmed PY - 2000/3/4/medline PY - 2000/2/17/entrez SP - 257 EP - 65 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am. J. Kidney Dis. VL - 35 IS - 2 N2 - Hypertension is a common problem in patients undergoing chronic hemodialysis. The purpose of this study is to identify the clinical and demographic factors independently associated with blood pressure in this population. Data collected for the Dialysis Morbidity and Mortality Study Wave 1 by the US Renal Data System were analyzed. The mean predialysis blood pressure for this cohort of 5,369 patients was 149/79 mm Hg. Sixty-three percent of the patients were hypertensive; 27%, 25%, and 11% had stages 1, 2, and 3 hypertension, respectively. Young age, black race, male sex, diabetes as cause of end-stage renal disease, erythropoietin therapy, and smoking were associated with higher blood pressure in the univariate analysis. Patients skipping or shortening one or more dialysis treatments had higher blood pressure. The presence of congestive heart failure and coronary heart disease was associated with lower blood pressure. On multivariate analysis, high interdialytic weight gain, noncompliance with dialysis regimen, and younger age were independent predictors of higher blood pressure. In summary, hypertension is common and poorly controlled in patients undergoing chronic hemodialysis. Greater interdialytic weight gain and noncompliance with dialysis regimen are independently associated with higher blood pressure, and advancing age is associated with lower blood pressure levels in this population. Therapeutic regimens emphasizing reduction of interdialytic weight gain and improved compliance with the dialysis regimen need to be evaluated for improving the management of hypertension. The effect of age and other comorbid conditions, particularly cardiovascular disease, must be considered while studying the relationship between blood pressure and mortality in patients undergoing chronic hemodialysis. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/10676725/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0272-6386(00)70335-0 DB - PRIME DP - Unbound Medicine ER -