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논문분류	춘계학술대회 초록집
제목	Interdialytic blood pressure variability and all-cause mortality in patients undergoing maintenance hemodialysis: a multicenter study using the DialysisNet
저자	Hyo Jin Kim
출판정보	2024; 2024(1):
키워드
초록	Objectives: Traditionally, the goal of blood pressure (BP) management is to control mean blood pressure, which is achieved by office BP measurement. However, the importance of BP variability has been increasingly emphasized recently. Therefore, this study aimed to analyze all-cause mortality according to interdialytic BP variability (BPV) in hemodialysis patients. Methods: Data on pre-dialysis BP and clinical information were extracted from four dialysis units through the DialysisNet system, which enables efficient HD management by utilizing common data elements. Interdialytic BPV was evaluated as the coefficient of variation (CV) of predialysis BP at each dialysis session over a 12-month period. The CV of systolic blood pressure (SBP) and diastolic blood pressure (DBP) was divided into tertiles. The primary outcome was all-cause mortality according to the CV of predialysis SBP, which was analyzed using Cox regression analysis. Results: Data of 357 hemodialysis patients (55.5% male), aged 62.9±13.2 years, with a median dialysis vintage of 24 (5–68) months, were analyzed. Patients in the third SBP CV tertile were older (P=0.010), had a higher prevalence of underlying diabetes (P=0.017), and had lower serum albumin levels (P=0.010). During a mean follow-up of 44.0±10.7 months, 55 (15.4%) patients died. Compared with the first SBP CV tertile, the third tertile showed significantly increased all-cause mortality after adjustment (hazard ratio [HR], 2.11; 95% confidence interval [CI], 1.04–4.24; P=0.037). Compared with the first DBP CV tertile, the third tertile showed significantly increased mortality in univariable analysis (HR, 2.18; 95% CI, 1.10–4.30; P=0.025) but not in multivariable analysis (HR, 1.88; 95% CI, 0.89–3.95; P=0.096). Conclusions: Increased interdialytic BPV in hemodialysis patients is associated with all-cause mortality. This was more prominent in SBP than in DBP. Particular attention should be paid to large BPVs in older adults, women, and patients with a relatively longer dialysis vintage.
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