Blood pressure control with active ultrafiltration measures and without antihypertensives is essential for survival in hemodiafiltration and hemodialysis programs for patients with CKD. A prospective observational study.
Published in Social Sciences, General & Internal Medicine, and Pharmacy & Pharmacology
The main finding confirms the hypothesis of the study that there is more remarkable survival in the group of patients with CKD whose hypertension can be controlled without antihypertensive treatment and with the use of constant dry weight reduction measures to optimize ultrafiltration. The factors associated with the lack of control of arterial hypertension were a history of vascular amputation, a history of being an ex-smoker, being a carrier of type 2 diabetes mellitus, having a serum ferritin level greater than 26.75%, being male, and being treated with hemodialysis. The associated protective factors were having a diagnosis of glomerulonephritis as an etiology of chronic kidney disease, a history of never smoking, a serum ALB concentration greater than 4.214 g/dl, effective blood flow greater than 423.5 ml/min, and interdialytic weight gain >4.925%, hemodiafiltration as treatment, urea levels less than 103.78 mg/dl, and fasting glucose levels less than 109.2 mg/dl. According to the time-adjusted model, only four factors were associated: age, transferrin saturation, serum albumin levels, and history of vascular amputation.
In the stratified analysis, differences in survival were demonstrated by the percentiles of blood pressure taken in the last month of survival or censoring. With blood pressures ranging from 141 mmHg to 122 mmHg, there is a proportional risk of death associated with the intake of antihypertensive agents. The same occurs when the blood pressure is less than 105 mmHg. These relationships could not be established with pressures greater than 141 mmHg.
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BMC Nephrology
This is an open access journal publishing original peer-reviewed research articles in all aspects of the prevention, diagnosis and management of kidney and associated disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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