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Importance of volume factors in dialysis related hypertension.
Clin Nephrol. 1997 Jul; 48(1):29-33.CN

Abstract

OBJECTIVE

To evaluate the relation between total body water and dialysis related hypertension.

PATIENTS AND METHODS

Thirty stable chronic hemodialysis patients were studied. Twenty-four-hour ambulatory blood pressure on the day before dialysis, blood pressure before and after dialysis, weight gain, ultrafiltration and total body water were determined. Total body water was measured by body impedance analysis and expressed as percentage of dry weight (TBW %). Ambulatory blood pressure recordings were defined as hypertensive when the blood pressure load (% of readings above 140/90 mmHg) was more than 40%.

RESULTS AND CONCLUSION

Patients, classified as normotensive (n = 11) or hypertensive (n = 19), based on 24-hour blood pressure measurements, had significantly different TBW % (54.7 +/- 5.3 vs. 58.9 +/- 4.6%, p = 0.046). Ambulatory blood pressure and postdialysis blood pressure, but not predialysis blood pressure, were significantly correlated with TBW %. Acute volume changes, as reflected by interdialytic weight gain and ultrafiltration did not correlate with TBW %. These changes correlated weakly with predialysis blood pressure. Multivariate analysis showed that only TBW % and antihypertensive medication had an independent influence on 24-hour blood pressure measurements. We conclude that 24-hour blood pressure and blood pressure after dialysis are better related to total body water than blood pressure before dialysis, which was however weakly related to the acute volume overload, induced by interdialytic weight gain. We hypothesize that this could be the result of a more important chronic volume overload leading to an increase in systemic vascular resistance. On the contrary the acute but less important changes in extracellular volume between dialyses cause no hypertension after dialysis and no sustained hypertension over 24 hours, but only in some cases a temporary increase in the blood pressure just before dialysis. This volume overload can be easily determined by measurement of total body water by bioelectrical impedance analysis.

Authors+Show Affiliations

Department of Nephrology-Hypertension, A. Z. Stuivenberg, Antwerpen, Belgium.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9247775

Citation

Lins, R L., et al. "Importance of Volume Factors in Dialysis Related Hypertension." Clinical Nephrology, vol. 48, no. 1, 1997, pp. 29-33.
Lins RL, Elseviers M, Rogiers P, et al. Importance of volume factors in dialysis related hypertension. Clin Nephrol. 1997;48(1):29-33.
Lins, R. L., Elseviers, M., Rogiers, P., Van Hoeyweghen, R. J., De Raedt, H., Zachee, P., & Daelemans, R. A. (1997). Importance of volume factors in dialysis related hypertension. Clinical Nephrology, 48(1), 29-33.
Lins RL, et al. Importance of Volume Factors in Dialysis Related Hypertension. Clin Nephrol. 1997;48(1):29-33. PubMed PMID: 9247775.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Importance of volume factors in dialysis related hypertension. AU - Lins,R L, AU - Elseviers,M, AU - Rogiers,P, AU - Van Hoeyweghen,R J, AU - De Raedt,H, AU - Zachee,P, AU - Daelemans,R A, PY - 1997/7/1/pubmed PY - 1997/7/1/medline PY - 1997/7/1/entrez SP - 29 EP - 33 JF - Clinical nephrology JO - Clin Nephrol VL - 48 IS - 1 N2 - OBJECTIVE: To evaluate the relation between total body water and dialysis related hypertension. PATIENTS AND METHODS: Thirty stable chronic hemodialysis patients were studied. Twenty-four-hour ambulatory blood pressure on the day before dialysis, blood pressure before and after dialysis, weight gain, ultrafiltration and total body water were determined. Total body water was measured by body impedance analysis and expressed as percentage of dry weight (TBW %). Ambulatory blood pressure recordings were defined as hypertensive when the blood pressure load (% of readings above 140/90 mmHg) was more than 40%. RESULTS AND CONCLUSION: Patients, classified as normotensive (n = 11) or hypertensive (n = 19), based on 24-hour blood pressure measurements, had significantly different TBW % (54.7 +/- 5.3 vs. 58.9 +/- 4.6%, p = 0.046). Ambulatory blood pressure and postdialysis blood pressure, but not predialysis blood pressure, were significantly correlated with TBW %. Acute volume changes, as reflected by interdialytic weight gain and ultrafiltration did not correlate with TBW %. These changes correlated weakly with predialysis blood pressure. Multivariate analysis showed that only TBW % and antihypertensive medication had an independent influence on 24-hour blood pressure measurements. We conclude that 24-hour blood pressure and blood pressure after dialysis are better related to total body water than blood pressure before dialysis, which was however weakly related to the acute volume overload, induced by interdialytic weight gain. We hypothesize that this could be the result of a more important chronic volume overload leading to an increase in systemic vascular resistance. On the contrary the acute but less important changes in extracellular volume between dialyses cause no hypertension after dialysis and no sustained hypertension over 24 hours, but only in some cases a temporary increase in the blood pressure just before dialysis. This volume overload can be easily determined by measurement of total body water by bioelectrical impedance analysis. SN - 0301-0430 UR - https://www.unboundmedicine.com/medline/citation/9247775/Importance_of_volume_factors_in_dialysis_related_hypertension_ L2 - https://medlineplus.gov/kidneyfailure.html DB - PRIME DP - Unbound Medicine ER -