Seasonal variation and predictors of intradialytic blood pressure decline: a retrospective cohort study

Kiyotaka Uchiyama, Keigo Shibagaki, Akane Yanai, Ei Kusahana, Takashin Nakayama, Kohkichi Morimoto, Naoki Washida, Hiroshi Itoh

研究成果: Article査読

2 被引用数 (Scopus)

抄録

The risk factors for intradialytic systolic blood pressure decline remain poorly understood. We aimed to identify clinical and laboratory predictors of the intradialytic systolic blood pressure decline, considering its seasonal variation. In a retrospective cohort of 47,219 hemodialysis sessions of 307 patients undergoing hemodialysis over one year in three dialysis clinics, the seasonal variation and the predictors of intradialytic systolic blood pressure decline (predialysis systolic blood pressure––nadir intradialytic systolic blood pressure) were assessed using cosinor analysis and linear mixed models adjusted for baseline or monthly hemodialysis-related variables, respectively. The intradialytic systolic blood pressure decline was greatest and least in the winter and summer, respectively, showing a clear seasonal pattern. In both models adjusted for baseline and monthly hemodialysis-related parameters, calcium channel blocker use was associated with a smaller decline (−4.58 [95% confidence interval (CI), −5.84 to −3.33], P < 0.001; −3.66 [95% CI, −5.69 to −1.64], P < 0.001) and α blocker use, with a greater decline (3.25 [95% CI, 1.53–4.97], P < 0.001; 3.57 [95% CI, 1.08–6.06], P = 0.005). Baseline and monthly serum phosphorus levels were positively correlated with the decline (1.55 [95% CI, 0.30–2.80], P = 0.02; 0.59 [95% CI, 0.16–1.00], P = 0.007), and baseline and monthly normalized protein catabolic rates were inversely correlated (respectively, −22.41 [95% CI, −33.53 to −11.28], P < 0.001; 9.65 [95% CI, 4.60–14.70], P < 0.001). In conclusion, calcium channel blocker use, α blocker avoidance, and serum phosphorus-lowering therapy may attenuate the intradialytic systolic blood pressure decline and should be investigated in prospective trials.

本文言語English
ページ(範囲)1417-1427
ページ数11
ジャーナルHypertension Research
44
11
DOI
出版ステータスPublished - 2021 11月

ASJC Scopus subject areas

  • 内科学
  • 生理学
  • 循環器および心血管医学

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