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Peripheral artery disease and blood pressure profile abnormalities in hemodialysis patients.
Viazzi, Francesca; Leoncini, Giovanna; Ratto, Elena; Storace, Giulia; Gonnella, Annalisa; Garneri, Debora; Bonino, Barbara; Cappadona, Francesca; Parodi, Emanuele L; Verzola, Daniela; Garibotto, Giacomo; Pontremoli, Roberto.
Afiliación
  • Viazzi F; Department of Internal Medicine, University of Genova and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Viale Benedetto XV, 16132, Genoa, Italy. francesca.viazzi@unige.it.
  • Leoncini G; Department of Internal Medicine, University of Genova and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Viale Benedetto XV, 16132, Genoa, Italy.
  • Ratto E; Department of Internal Medicine, University of Genova and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Viale Benedetto XV, 16132, Genoa, Italy.
  • Storace G; Department of Internal Medicine, University of Genova and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Viale Benedetto XV, 16132, Genoa, Italy.
  • Gonnella A; Department of Internal Medicine, University of Genova and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Viale Benedetto XV, 16132, Genoa, Italy.
  • Garneri D; Department of Internal Medicine, University of Genova and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Viale Benedetto XV, 16132, Genoa, Italy.
  • Bonino B; Department of Internal Medicine, University of Genova and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Viale Benedetto XV, 16132, Genoa, Italy.
  • Cappadona F; Department of Internal Medicine, University of Genova and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Viale Benedetto XV, 16132, Genoa, Italy.
  • Parodi EL; Department of Internal Medicine, University of Genova and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Viale Benedetto XV, 16132, Genoa, Italy.
  • Verzola D; Department of Internal Medicine, University of Genova and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Viale Benedetto XV, 16132, Genoa, Italy.
  • Garibotto G; Department of Internal Medicine, University of Genova and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Viale Benedetto XV, 16132, Genoa, Italy.
  • Pontremoli R; Department of Internal Medicine, University of Genova and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Viale Benedetto XV, 16132, Genoa, Italy.
J Nephrol ; 30(3): 427-433, 2017 Jun.
Article en En | MEDLINE | ID: mdl-27250350
BACKGROUND: Patients undergoing chronic hemodialysis (HD) are at increased risk for peripheral artery disease (PAD). Both ankle-brachial index (ABI) and ambulatory blood pressure monitoring (ABPM) in the interdialytic period have been shown to be strong predictors of all-cause mortality. METHODS: This cross-sectional study investigated the relationship between ABPM profile and ABI in 81 HD patients. ABPM was measured throughout a 44-h midweek interdialytic period. Pre-dialysis ABI was evaluated with a BOSO ABI device. An ABI value <0.9 or ≥1.3 was defined as abnormal. RESULTS: In the whole study group (72 % males, mean age 67 ± 14 years), there was an increase in BP (p < 0.05) and in systolic BP night/day ratio (n/dSR, p = 0.01) during the interdialytic period. Patients with abnormal ABI (n = 29) more frequently had a positive history for cerebrovascular accident and PAD and higher proBNP values than those with normal ABI (n = 52). No difference was detected among ABPM-derived components except for the n/dSR (p = 0.02). Patients with abnormal ABI showed a significantly increased n/dSR (p = 0.02) and ambulatory arterial stiffness index (AASI) (p = 0.006) on the second day compared to the first. Patients with n/dSR >1 during day 2 (n = 34) were older, showed significantly higher proBNP and AASI and were more likely to reveal abnormal ABI compared to those with a lower n/dSR (p = 0.006). CONCLUSIONS: Abnormal ABI in HD patients is associated to changes in interdialytic ABPM pattern, namely higher n/dSR on day 2. These data may indicate the pathophysiological mechanisms underlying the worse outcome observed in HD patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Presión Sanguínea / Diálisis Renal / Enfermedad Arterial Periférica / Rigidez Vascular / Hipertensión / Fallo Renal Crónico Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Nephrol Asunto de la revista: NEFROLOGIA Año: 2017 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Italia
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Presión Sanguínea / Diálisis Renal / Enfermedad Arterial Periférica / Rigidez Vascular / Hipertensión / Fallo Renal Crónico Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Nephrol Asunto de la revista: NEFROLOGIA Año: 2017 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Italia