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Chinese Journal of Blood Purification ›› 2007, Vol. 6 ›› Issue (1) : 10-13.

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Abstract

Objective To analyze the relationship between the parameters of 24-hour ambulatory blood pressure monitoring (ABPM) and cardiac function in maintenance hemodialysis (MHD) patients. Methods Thirty-one MHD patients and 31 pre-ESRD patients were enrolled. 24-hour average systolic (24h-SBP), 24-hour average diastolic (24h- DBP),24-hour average mean arterial(24h-MAP), Daytime average systolic(D-SBP),Daytime average diastolic (D-DBP), Nighttime average systolic(N-SBP), Nighttime average diastolic(N-DBP) blood pressure and circadian blood pressure rhythm were measured by ABPM. The left ventricular end-diastolic diameter(LVDd), left ventricular end-systolic diameter(LVDs),left atrial diameter(LAD),left ventricular posterior wall thickness(LVPWT),interventricular septal thickness(IVST)were detected by ultrasonic cardiography. And other correlated parameters were also measured. Results The left ventricular hypertrophy (LVH), LVDd, LVDs and LVMI increased in MHD patients compared with pre-ESRD patients, while the fractional shortening decreased significantly. The levels of 24h-SBP，24h-DBP，24h-MAP, D-SBP， D-DBP， N-SBP and N-DBP increased significantly in MHD patients compared with the pre-ESRD patients, especially the non-dipper hypertension(90.3% vs 64.5%,P= 0.015). The percentage of hypertension at 24-hour average, Daytime average, Nighttime average blood pressure and N-SBP were higher in MHD patients compared with the control group. The non-dipper blood pressure in MHD patients whose 24-hour average blood pressure lower than 135/85mm Hg were 87.5%. The blood pressure was found positively correlated with cardiac function, especially the SBP and non-dipper blood pressure rhythm. On the other hand, Alb、iPTH、duration of hemodialysis were also correlated with cardiac function. Conclusion The incidence of hypertension and non-dipper hypertension is very high in MHD patients. The cardiac function in maintenance hemodialysis is closely correlated with non-dipper blood pressure rhythm and high N-SBP.