The Optimal Blood Pressure Target in Different Dialysis Populations

Jong Hyun Jhee, Jimin Park, Hyoungnae Kim, Youn Kyung Kee, Jung Tak Park, Seung Hyeok Han, Chul Woo Yang, Nam Ho Kim, Yon Su Kim, Shin Wook Kang, Yong Lim Kim, Tae Hyun Yoo

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Abstract

Hypertension is common and contributes to adverse outcomes in patients undergoing dialysis. However, the proper blood pressure (BP) target remains controversial and several factors make this difficult. This study aimed to investigate the adequate BP target in patients undergoing prevalent dialysis. Data were retrieved from the Clinical Research Center for End-Stage Renal Disease (2009–2014). 2,299 patients undergoing dialysis were evaluated. Patients were assigned into eight groups according to predialysis systolic blood pressure (SBP). The primary outcome was all-cause mortality. During the median follow-up of 4.5 years, a U-shape relation between SBP and mortality was found. The risk of mortality was increased in the SBP <110 and ≥170 mmHg groups. In subgroup analysis, the risk of mortality was similarly shown U-shape with SBP in subjects with no comorbidities, and no use of antihypertensive agents. However, only lowest SBP was a risk factor for mortality in patients with older, having diabetes or coronary artery disease, whereas highest SBP was an only risk factor in younger patients. In respect of dialysis characteristics, patients undergoing hemodialysis showed U-shape between SBP and mortality, while patients undergoing peritoneal dialysis did not. Among hemodialysis patients, patients with shorter dialysis vintage and less interdialytic weight gain showed U-shape association between SBP and mortality. This study showed that the lowest or highest SBP group had higher risk of mortality. Nevertheless, the optimal target BP should be applied according to individual condition of each patient.

Original languageEnglish
Article number14123
JournalScientific reports
Volume8
Issue number1
DOIs
Publication statusPublished - 2018 Dec 1

All Science Journal Classification (ASJC) codes

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    Jhee, J. H., Park, J., Kim, H., Kee, Y. K., Park, J. T., Han, S. H., Yang, C. W., Kim, N. H., Kim, Y. S., Kang, S. W., Kim, Y. L., & Yoo, T. H. (2018). The Optimal Blood Pressure Target in Different Dialysis Populations. Scientific reports, 8(1), [14123]. https://doi.org/10.1038/s41598-018-32281-w