Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, Guizhou, China.
Renal Division, Department of Medicine, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China.
Pediatr Res. 2018 Mar;83(3):615-621. doi: 10.1038/pr.2017.293. Epub 2018 Jan 3.
BackgroundPre-dialysis blood pressure variability (BPV) in adolescent and young-adult maintenance hemodialysis (MHD) patients remains unknown. This study aimed to show the degree of 44-h BPV and to explore its related risk factors in adolescent and young-adult MHD patients.MethodsOne hundred and fifty-three hemodialysis patients aged from 14 to 29 were selected from 11 medical facilities in Guizhou, China. Variability independent of the mean BP (VIM) obtained by 44-h ambulatory BP monitoring was used to calculate BPV. Baseline characteristics, physical measurement, and laboratory parameters were compared between different groups categorized by quartiles of VIM of systolic BP (VIMSBP).ResultsVIMSBP levels were found to be positively related to interdialytic weigh growth rate (IDWG), serum phosphorus, and serum intact parathyroid hormone (iPTH; Spearman correlation coefficients 0.474, 0.229, and 0.437, respectively; P<0.05 for all) and negatively related to hemoglobin (Hb) and albumin (-0.317, P<0.001, and -0.166, P=0.04, respectively) in all adolescent and young-adult MHD patients. In multiple linear regression analysis, IDWG, Hb, serum phosphorus, and serum iPTH had an independent association with VIMSBP.ConclusionOur analysis revealed an independent association of BPV with IDWG, Hb, serum phosphorus, and serum iPTH among adolescent and young-adult patients undergoing dialysis. This observation warrants further study.
青少年和青年维持性血液透析（MHD）患者透析前血压变异性（BPV）仍不清楚。本研究旨在显示 44 小时 BPV 的程度，并探讨其在青少年和青年 MHD 患者中的相关危险因素。
从中国贵州的 11 家医疗机构中选择了 153 名年龄在 14 至 29 岁的血液透析患者。通过 44 小时动态血压监测获得的均值独立变异（VIM）用于计算 BPV。根据收缩压 VIM（VIMSBP）的四分位数将患者分为不同的组，比较各组间的基本特征、体格检查和实验室参数。
VIMSBP 水平与透析间体重增长率（IDWG）、血清磷和血清全段甲状旁腺激素（iPTH）呈正相关（Spearman 相关系数分别为 0.474、0.229 和 0.437；P<0.05 均），与血红蛋白（Hb）和白蛋白呈负相关（-0.317，P<0.001 和-0.166，P=0.04）。在多元线性回归分析中，IDWG、Hb、血清磷和血清 iPTH 与 VIMSBP 独立相关。
我们的分析表明，BPV 与 IDWG、Hb、血清磷和血清 iPTH 与青少年和青年透析患者独立相关。这一观察结果值得进一步研究。
