a Department of Nephrology , Beijing Tiantan Hospital, Capital Medical University , Beijing , China.
b Department of Clinical Nutrition , Peking University First Hospital , Beijing , China.
Ren Fail. 2018 Nov;40(1):259-264. doi: 10.1080/0886022X.2018.1456456.
To investigate the association of short-term blood pressure variability (BPV) with cardiovascular mortality in hemodialysis (HD) patients, using a reliable index called average real variability (ARV), and to assess the factors associated with ARV in incident HD population.
A total of 103 HD patients were recruited, with 44-h ambulatory blood pressure monitoring performed after the midweek HD session. Systolic BPV was assessed by SD, coefficient of variation (CV), and ARV, respectively. Laboratory data were obtained from blood samples before the midweek HD. All patients were followed up for 24 months.
According to the median of BPV indices, the comparisons between patients with the low and high values were conducted. Kaplan-Meier analysis showed the survival curves corresponding to median of SD and CV exhibit similar performance for the low and high groups (p = .647, p = .098, respectively). In contrast, patients with higher ARV had a lower survival rate than those with lower ARV (77.8% vs. 98.0%, p = .002). After adjustment for demographics and clinical factors, ARV (HR: 1.143; 95% CI: 1.022-1.279, p = .019) and high-sensitivity C-reactive protein (HR: 1.394; 95% CI: 1.025-1.363, p = .021) were associated with increased risk of cardiovascular mortality in HD patients. Age and interdialytic weight gain (IDWG) were related factors for ARV (β = 0.065, p = .005; β = 0.825, p = .003, respectively).
Greater ARV was independently associated with increased risk of cardiovascular mortality in HD patients. Age and IDWG were independent related factors for ARV.
使用可靠指标平均真实变异性（ARV），研究血液透析（HD）患者短期血压变异性（BPV）与心血管死亡率的关系，并评估初发 HD 患者中与 ARV 相关的因素。
共纳入 103 例 HD 患者，在每周中 HD 治疗后进行 44 小时动态血压监测。分别用标准差（SD）、变异系数（CV）和 ARV 评估收缩压 BPV。从每周中 HD 前的血液样本中获得实验室数据。所有患者均随访 24 个月。
根据 BPV 指数中位数，对低值和高值患者进行比较。Kaplan-Meier 分析显示，SD 和 CV 中位数的生存曲线在低值和高值组的表现相似（p=0.647，p=0.098）。相比之下，ARV 较高的患者生存率低于 ARV 较低的患者（77.8% vs. 98.0%，p=0.002）。在校正人口统计学和临床因素后，ARV（HR：1.143；95%CI：1.022-1.279，p=0.019）和高敏 C 反应蛋白（HR：1.394；95%CI：1.025-1.363，p=0.021）与 HD 患者心血管死亡率增加相关。年龄和透析间体重增加（IDWG）是 ARV 的相关因素（β=0.065，p=0.005；β=0.825，p=0.003）。
更大的 ARV 与 HD 患者心血管死亡率增加独立相关。年龄和 IDWG 是 ARV 的独立相关因素。
