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Blood pressure variability is an independent predictor of adverse clinical events in hemodialysis patients. Volume overload is one of the most important factors affecting blood pressure homeostasis. In the present study, we explored the effects of dry weight reduction on home blood pressure variability in volume overload hemodialysis patients. Hemodialysis patients with volume overload had their dry weight gradually decreased under the guidance of bioimpedance methods, which was represented by calf bioimpedance ratio (Calf-BR). Home blood pressure was measured on waking up and at bedtime for one week at baseline and at the end of the two-month study. Coefficient of variation was used to define home blood pressure variability. Thirty-eight hemodialysis patients had their dry weight significantly decreased from 60.7 ± 11.3 to 59.6 ± 10.7 (p = 0.003) accompanied with a significant reduction in calf-BR (0.828 ± 0.023 versus 0.786 ± 0.020, p<0.001). The systolic and diastolic blood pressure decreased significantly. Moreover, the whole-day, morning and evening systolic blood pressure variability gradually and significantly decreased by the end of the study (5.6 ± 2.1 versus 4.0 ± 1.7, p<0.001; 7.7 ± 3.5% versus 6.3 ± 2.7%, p = 0.005; 7.5 ± 2.8% versus 5.9 ± 2.3%, p = 0.002, respectively). Diastolic blood pressure variability parameters were unchanged. The interdialytic weight gain and the incidence of adverse events were similar throughout the study period. Gradually dry weight reduction by bioimpedance methods improved home blood pressure variability in hemodialysis patients with chronic fluid overload. This article is protected by copyright. All rights reserved.
This article was published in the following journal.
Name: Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy
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Long-term maintenance hemodialysis in the home.
A method of mechanical ventilation in which pressure is maintained to increase the volume of gas remaining in the lungs at the end of expiration, thus reducing the shunting of blood through the lungs and improving gas exchange.
The measure of a BLOOD VESSEL's ability to increase the volume of BLOOD it holds without a large increase in BLOOD PRESSURE. The vascular capacitance is equal to the change in volume divided by the change in pressure.
Phenomenon where increased BLOOD PRESSURE readings taken in non-clinical settings (e.g., HOME BLOOD PRESSURE MONITORING) do not replicate in clinical settings.
Extracorporeal ultrafiltration technique without hemodialysis for treatment of fluid overload and electrolyte disturbances affecting renal, cardiac, or pulmonary function.