Chronobiology of Arterial Hypertension in Hemodialysis Patients: Implications for Home Blood Pressure Monitoring

摘要: Background Hemodialysis patients have a steady increase in blood pressure (BP) during the 44-hour interdialytic interval when ambulatory BP monitoring is used. Home recording allows for longer period of between dialysis treatments and may better define chronobiological characteristics arterial hypertension. This study sought to determine optimal time perform home hemodialysis improve strength prediction BP. Study Design Diagnostic test study. Setting & Participants an ancillary analysis participating Dry-weight Reduction Hypertensive Patients (DRIP) trial. Index Test measured 3 times daily 1 week by using validated oscillometric monitor on occasions at 4-week intervals after randomization. first third, second last third elapsed treatment, as well each was compared with overall Reference Tests Interdialytic Results During interval, we found systolic 0.30 ± 0.36 mm Hg/h 0.40 0.25 Hg/h. relationship reached plateau approximately 48 hours. A similar pattern seen diastolic Probing dry weight steepened slope BP, but did not alter time-dependent average higher (bias) 14.1 (95% confidence 12.0 16.2)/5.7 Hg 4.6 6.9). The SD differences methods (precision) 4.6/2.8 Hg. Measurement gave best precision, model fit measurements. Limitations Our cohort overrepresented African American patients. Whether participants different response than non–African known. Conclusions findings suggest that treatment must be considered interpreting recordings likely yield most reliable estimate.