Serum sodium variation is a major determinant of peridialytic blood pressure trends in haemodialysis outpatients

Abstract Intradialytic hypotension (IDH) and peridialytic blood pressure (BP) trends are associated with morbidity and mortality in haemodialysis (HD) patients. We aimed to characterise the respective influence of volume status and small solutes variation on peridialytic systolic BP (SBP) trends dur...

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Autores principales:	David A. Jaques, Andrew Davenport
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/c9e987dc49ad4c1398e58b34437e80f9
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spelling	oai:doaj.org-article:c9e987dc49ad4c1398e58b34437e80f92021-12-02T18:03:07ZSerum sodium variation is a major determinant of peridialytic blood pressure trends in haemodialysis outpatients10.1038/s41598-021-86960-22045-2322https://doaj.org/article/c9e987dc49ad4c1398e58b34437e80f92021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-86960-2https://doaj.org/toc/2045-2322Abstract Intradialytic hypotension (IDH) and peridialytic blood pressure (BP) trends are associated with morbidity and mortality in haemodialysis (HD) patients. We aimed to characterise the respective influence of volume status and small solutes variation on peridialytic systolic BP (SBP) trends during HD. We retrospectively analysed the relative peridialytic SBP decrease in 647 prevalent outpatients attending for their mid-week session with corresponding pre- and post-HD bioelectrical impedance analysis. Mean SBP decreased by 10.5 ± 23.6 mmHg. Factors positively associated with the relative decrease in SBP were: serum sodium (Na) decrease, body mass index, serum albumin, dialysis vintage, ultrafiltration rate and urea Kt/V (p < 0.05 for all). Antihypertensive medications and higher dialysate calcium were negatively associated with the relative decrease in SBP (p < 0.05 for both). Age had a quadratic relationship with SBP trends (p < 0.05). Pre-HD volume status measured by extracellular to total body water ratio was not associated with SBP variation (p = 0.216). Peridialytic SBP trends represent a continuum with serum Na variation being a major determinant while volume status has negligible influence. Middle-aged and overweight patients are particularly prone to SBP decline. Tailoring Na and calcium dialysate concentrations could influence haemodynamic stability during HD and improve patient experience and outcomes.David A. JaquesAndrew DavenportNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q David A. Jaques Andrew Davenport Serum sodium variation is a major determinant of peridialytic blood pressure trends in haemodialysis outpatients
description	Abstract Intradialytic hypotension (IDH) and peridialytic blood pressure (BP) trends are associated with morbidity and mortality in haemodialysis (HD) patients. We aimed to characterise the respective influence of volume status and small solutes variation on peridialytic systolic BP (SBP) trends during HD. We retrospectively analysed the relative peridialytic SBP decrease in 647 prevalent outpatients attending for their mid-week session with corresponding pre- and post-HD bioelectrical impedance analysis. Mean SBP decreased by 10.5 ± 23.6 mmHg. Factors positively associated with the relative decrease in SBP were: serum sodium (Na) decrease, body mass index, serum albumin, dialysis vintage, ultrafiltration rate and urea Kt/V (p < 0.05 for all). Antihypertensive medications and higher dialysate calcium were negatively associated with the relative decrease in SBP (p < 0.05 for both). Age had a quadratic relationship with SBP trends (p < 0.05). Pre-HD volume status measured by extracellular to total body water ratio was not associated with SBP variation (p = 0.216). Peridialytic SBP trends represent a continuum with serum Na variation being a major determinant while volume status has negligible influence. Middle-aged and overweight patients are particularly prone to SBP decline. Tailoring Na and calcium dialysate concentrations could influence haemodynamic stability during HD and improve patient experience and outcomes.
format	article
author	David A. Jaques Andrew Davenport
author_facet	David A. Jaques Andrew Davenport
author_sort	David A. Jaques
title	Serum sodium variation is a major determinant of peridialytic blood pressure trends in haemodialysis outpatients
title_short	Serum sodium variation is a major determinant of peridialytic blood pressure trends in haemodialysis outpatients
title_full	Serum sodium variation is a major determinant of peridialytic blood pressure trends in haemodialysis outpatients
title_fullStr	Serum sodium variation is a major determinant of peridialytic blood pressure trends in haemodialysis outpatients
title_full_unstemmed	Serum sodium variation is a major determinant of peridialytic blood pressure trends in haemodialysis outpatients
title_sort	serum sodium variation is a major determinant of peridialytic blood pressure trends in haemodialysis outpatients
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/c9e987dc49ad4c1398e58b34437e80f9
work_keys_str_mv	AT davidajaques serumsodiumvariationisamajordeterminantofperidialyticbloodpressuretrendsinhaemodialysisoutpatients AT andrewdavenport serumsodiumvariationisamajordeterminantofperidialyticbloodpressuretrendsinhaemodialysisoutpatients
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Serum sodium variation is a major determinant of peridialytic blood pressure trends in haemodialysis outpatients

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