Blood pressure profile in continuous ambulatory peritoneal dialysis patients

Rizna Abdul Cader, Abdul Halim Abdul Gafor, Rozita Mohd, Suriani Ibrahim, W. H. Wan Haslina, Arba'iyah Bain, Norella C T Kong

Research output: Contribution to journalArticle

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Abstract

Background: Cardiovascular mortality is the leading cause of death in end stage renal disease. Despite being on continuous ambulatory peritoneal dialysis (CAPD), blood pressure (BP) remains poorly controlled. A higher pulse pressure and non dipping are associated with increased cardiovascular mortality. We studied BP control and the prevalence of non dipping in CAPD patients. Methods: All patients undergoing CAPD at our institution who met the inclusion criteria were recruited. We compared BP control and dipping status in diabetic and non diabetic patients on CAPD. We also determined whether BP and peritoneal membrane permeability were associated. Results: Forty six patients with a mean age 45 ± 13 years were enrolled. Diabetic patients were older (mean age 54 ± 13 vs. 40 ± 11 yrs, p <0.001), had a lower mean diastolic BP (80 ± 14 vs. 90 ± 14 mmHg, p = 0.025) and a higher mean pulse pressure (59 ± 17 vs. 49 ± 14 mmHg, p = 0.035). They were also non dippers (n = 15 vs. n = 1, p = 0.007). The low and low average transporters tended to have a higher systolic BP (p = 0.054) and a higher pulse pressure (p = 0.058). On multivariate analysis, age was the main predictor of pulse pressure. Conclusion: Despite being on chronic maintenance PD, BP was not well controlled. Diabetic patients had a higher pulse pressure and were non dippers thereby increasing their cardiovascular risk. We should therefore optimize BP control and aim to restore the nocturnal dip in these patients.

Original languageEnglish
Pages (from-to)116-124
Number of pages9
JournalEXCLI Journal
Volume11
Publication statusPublished - 2012

Fingerprint

Continuous Ambulatory Peritoneal Dialysis
dialysis
blood pressure
Blood Pressure
dipping
diastolic blood pressure
membrane permeability
systolic blood pressure
kidney diseases
multivariate analysis
transporters
death
Mortality
Chronic Kidney Failure
Cause of Death
Permeability

Keywords

  • Ambulatory blood pressure monitoring
  • Cardiovascular mortality
  • Continuous ambulatory peritoneal dialysis
  • Diabetes mellitus
  • Dipping
  • Diurnal variation
  • Pulse pressure

ASJC Scopus subject areas

  • Molecular Medicine
  • Pharmacology
  • Drug Discovery
  • Animal Science and Zoology

Cite this

Blood pressure profile in continuous ambulatory peritoneal dialysis patients. / Abdul Cader, Rizna; Abdul Gafor, Abdul Halim; Mohd, Rozita; Ibrahim, Suriani; Wan Haslina, W. H.; Bain, Arba'iyah; Kong, Norella C T.

In: EXCLI Journal, Vol. 11, 2012, p. 116-124.

Research output: Contribution to journalArticle

Abdul Cader, Rizna ; Abdul Gafor, Abdul Halim ; Mohd, Rozita ; Ibrahim, Suriani ; Wan Haslina, W. H. ; Bain, Arba'iyah ; Kong, Norella C T. / Blood pressure profile in continuous ambulatory peritoneal dialysis patients. In: EXCLI Journal. 2012 ; Vol. 11. pp. 116-124.
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AU - Abdul Cader, Rizna

AU - Abdul Gafor, Abdul Halim

AU - Mohd, Rozita

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AU - Wan Haslina, W. H.

AU - Bain, Arba'iyah

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N2 - Background: Cardiovascular mortality is the leading cause of death in end stage renal disease. Despite being on continuous ambulatory peritoneal dialysis (CAPD), blood pressure (BP) remains poorly controlled. A higher pulse pressure and non dipping are associated with increased cardiovascular mortality. We studied BP control and the prevalence of non dipping in CAPD patients. Methods: All patients undergoing CAPD at our institution who met the inclusion criteria were recruited. We compared BP control and dipping status in diabetic and non diabetic patients on CAPD. We also determined whether BP and peritoneal membrane permeability were associated. Results: Forty six patients with a mean age 45 ± 13 years were enrolled. Diabetic patients were older (mean age 54 ± 13 vs. 40 ± 11 yrs, p <0.001), had a lower mean diastolic BP (80 ± 14 vs. 90 ± 14 mmHg, p = 0.025) and a higher mean pulse pressure (59 ± 17 vs. 49 ± 14 mmHg, p = 0.035). They were also non dippers (n = 15 vs. n = 1, p = 0.007). The low and low average transporters tended to have a higher systolic BP (p = 0.054) and a higher pulse pressure (p = 0.058). On multivariate analysis, age was the main predictor of pulse pressure. Conclusion: Despite being on chronic maintenance PD, BP was not well controlled. Diabetic patients had a higher pulse pressure and were non dippers thereby increasing their cardiovascular risk. We should therefore optimize BP control and aim to restore the nocturnal dip in these patients.

AB - Background: Cardiovascular mortality is the leading cause of death in end stage renal disease. Despite being on continuous ambulatory peritoneal dialysis (CAPD), blood pressure (BP) remains poorly controlled. A higher pulse pressure and non dipping are associated with increased cardiovascular mortality. We studied BP control and the prevalence of non dipping in CAPD patients. Methods: All patients undergoing CAPD at our institution who met the inclusion criteria were recruited. We compared BP control and dipping status in diabetic and non diabetic patients on CAPD. We also determined whether BP and peritoneal membrane permeability were associated. Results: Forty six patients with a mean age 45 ± 13 years were enrolled. Diabetic patients were older (mean age 54 ± 13 vs. 40 ± 11 yrs, p <0.001), had a lower mean diastolic BP (80 ± 14 vs. 90 ± 14 mmHg, p = 0.025) and a higher mean pulse pressure (59 ± 17 vs. 49 ± 14 mmHg, p = 0.035). They were also non dippers (n = 15 vs. n = 1, p = 0.007). The low and low average transporters tended to have a higher systolic BP (p = 0.054) and a higher pulse pressure (p = 0.058). On multivariate analysis, age was the main predictor of pulse pressure. Conclusion: Despite being on chronic maintenance PD, BP was not well controlled. Diabetic patients had a higher pulse pressure and were non dippers thereby increasing their cardiovascular risk. We should therefore optimize BP control and aim to restore the nocturnal dip in these patients.

KW - Ambulatory blood pressure monitoring

KW - Cardiovascular mortality

KW - Continuous ambulatory peritoneal dialysis

KW - Diabetes mellitus

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KW - Diurnal variation

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