ESPN 54th Annual Meeting

ESPN 2022


 
AMBULATORY BLOOD PRESSURE MONITORING AND PULSE WAVE ANALYSIS PROFILES IN PERITONEAL DIALYSIS AND HEMODIALYSIS PATIENTS
STELLA STABOULI 1 VARVARA ASKITI 2 ATHANASIA CHAINOGLOU 1 GEORGIA MALAKASIOTI 2 VASILIKI KARAVA 1 MARIA MILA 2 KATERINA CHRYSAIDOU 1 SMARARGI MARINAKI 3 ANDROMACHI MITSIONI 2

1- FIRST PEDIATRIC DEPARTMENT, MEDICAL SCHOOL, FACULTY OF HEALTH SCIENCES, ARISTOTLE UNIVERSITY THESSALONIKI, HIPPOKRATIO HOSPITAL, THESSALONIKI, GREECE
2- NEPHROLOGY DEPARTMENT, “P&A KYRIAKOU” CHILDREN’S HOSPITAL, ATHENS, GREECE
3- CLINIC OF NEPHROLOGY AND RENAL TRANSPLANTATION, NATIONAL AND KAPODISTRIAN UNIVERSITY OF ATHENS, MEDICAL SCHOOL, ATHENS, GREECE
 
Introduction:

Hypertension is highly prevalent in the chronic kidney disease population and associates with higher cardiovascular morbidity. The aim of the study was to compare ambulatory blood pressure monitoring (ABPM) and pulse wave analysis (PWA) profiles in children on peritoneal dialysis (PD) and hemodialysis (HD).

Material and methods:

A cohort of 16 patients on PD and 12 on HD, aged 6 to 18 years, underwent ABPM and PWA using the oscillometric Mobil-O-Graph device during the 48h interdialytic period in HD or for 24h in PD.

Results:

The prevalence of hypertension was 50% in the PD and 66.7% in the HD group. PD and HD patients did not differ in age (12.9±3.4 vs 10.9±2.5 years, p=0.1), mean arterial pressure (MAP) (93.1±17.6 vs 91.7±7.6 mmHg, p=0.7) central SBP (93.9±19.9 vs 96.6±10.1 mmHg, p=0.6) and pulse wave velocity (PWV) levels (4.1±0.6 vs 4.2±0.4 m/sec, p=0.6). The differences remained non-significant when age- or height-adjusted z-scores were used. However, heart rate-adjusted augmentation index (AIx75) (22.1±9.9 vs 30.5±6.1 %, p<0.05), cardiac index (CI) (3.3±0.5 vs 4.3±0.9 l/m2, p<0.005), and HR (84.9±12.6 vs 94.2±9.3 beats/min, p<0.5) were significantly higher in the HD group. In HD patients, MAP and central SBP showed significant increases from the first to the second monitoring day (91.5±5.3 vs 96.3±6.1, p<0.001, and 103.9±5.2 vs 108.4±5.6, mmHg, p<0.005, respectively), while AIx75, Cl and PWV presented similar values in both days. The differences in MAP central SBP and PWV between PD and HD patients remained non-significant both in the first and second monitoring day. 

Conclusions:

Despite gradual BP increases during the interdialytic period in HD, PD patients had comparable BP and PWV levels suggesting similar cardiovascular risk between the different dialysis modalities. However, the increased levels of AIx75 and CI in HD patients could imply different patterns of vascular and cardiac functional changes.