Bezerra Rodrigo, Gorayeb-Polacchini Fernanda S, Teles Flavio, Pinto Luís Cláudio S, Tome Ana Carolina N, Bidoia Marcela P, Rezende Carolina S, Barreto Joaquim, Amazonas Roberto B, Sposito Andrei C, Lima Gabriel Q, Anjos Gabriel S, Feitosa Audes D M, Nadruz Wilson
Pronto Socorro Cardiológico de Pernambuco (PROCAPE), University of Pernambuco, Recife, PE, Brazil.
Department of Nephrology, School of Medicine of São José do Rio Preto (FAMERP), Hospital de Base, São José do Rio Preto, SP, Brazil.
Hypertens Res. 2025 Mar;48(3):1169-1173. doi: 10.1038/s41440-025-02103-4. Epub 2025 Jan 16.
In hemodialysis patients, blood pressure (BP) measured at the postdialysis period (POSBP) can be used to diagnose hypertension. However, the optimal time point for POSBP remains uncertain. This cross-sectional study evaluated 210 long-term dialysis patients (66.7% men; age = 56.9 ± 15.7 years), who underwent POSBP measurements at three time points [immediately after dialysis period ended (POSBP1); after blood return (POSBP2) and after fistula hemostasis or catheter sealing (POSBP3)] and home BP monitoring (HBPM) over one week. POSBP1, POSBP2, POSBP3 and HBPM values were 139.1 ± 22.4/73.2 ± 12.5, 142.8 ± 22.8/74.3 ± 12.3, 142.8 ± 21.8/74.0 ± 12.2 and 131.2 ± 21.2/77.9 ± 12.1 mmHg, respectively. Systolic POSBP3 and POSBP2 were significantly greater (p < 0.05) than systolic POSBP1. POSBP3 had the greatest correlation with HBPM, while elevated (>130/80 mmHg) POSBP3 showed the highest numerical accuracy (AUC [95% CI] = 0.696 [0.638-0.754]) and concordance (kappa coefficient = 0.41) with elevated HBPM (≥130/80 mmHg) compared with POSBP1 and POSBP2. These findings suggest that POSBP3 may be a preferable measurement for assessment of POSBP in hemodialysis patients.
在血液透析患者中，透析后阶段（POSBP）测量的血压（BP）可用于诊断高血压。然而，POSBP的最佳时间点仍不确定。这项横断面研究评估了210名长期透析患者（男性占66.7%；年龄=56.9±15.7岁），这些患者在三个时间点进行了POSBP测量[透析阶段结束后立即测量（POSBP1）；回血后测量（POSBP2）以及内瘘止血或导管封堵后测量（POSBP3）]，并进行了为期一周的家庭血压监测（HBPM）。POSBP1、POSBP2、POSBP3和HBPM的值分别为139.1±22.4/73.2±12.5、142.8±22.8/74.3±12.3、142.8±21.8/74.0±12.2和131.2±21.2/77.9±12.1mmHg。收缩压POSBP3和POSBP2显著高于收缩压POSBP1（p<0.05）。POSBP3与HBPM的相关性最强，与POSBP1和POSBP2相比，升高（>130/80mmHg）的POSBP3在数值准确性（AUC[95%CI]=0.696[0.638 - 0.754]）和与升高的HBPM（≥130/80mmHg）的一致性（kappa系数=0.41）方面表现最高。这些发现表明，POSBP3可能是评估血液透析患者POSBP的更优测量方法。
