PMID- 29870977
OWN - NLM
STAT- MEDLINE
DCOM- 20181022
LR  - 20240412
IS  - 1423-0143 (Electronic)
IS  - 1420-4096 (Print)
IS  - 1420-4096 (Linking)
VI  - 43
IP  - 3
DP  - 2018
TI  - Association of Intradialytic Hypertension with Left Ventricular Mass in 
      Hypertensive Hemodialysis Patients Enrolled in the Blood Pressure in Dialysis 
      (BID) Study.
PG  - 882-892
LID - 10.1159/000490336 [doi]
AB  - BACKGROUND/AIMS: Intradialytic hypertension (IDH), or paradoxical rise in blood 
      pressure (BP) during hemodialysis (HD) is associated with increased morbidity and 
      mortality. The association between IDH and increased left ventricular mass (LVM), 
      a well-known risk factor for adverse cardiovascular outcomes in HD patients, has 
      not been studied. The aim of our study is to evaluate the cross-sectional 
      association of intradialytic change in BP with cardiac structure and function 
      measured by cardiac MRI in hypertensive HD patients enrolled in the multi-center 
      Blood Pressure in Dialysis (BID) clinical trial. METHODS: Participants in the BID 
      study were categorized into 3 groups based on average change (Delta) in systolic 
      blood pressure (SBP) (post-HD SBP minus pre-HD SBP) during HD over a 1 month 
      period: group 1 - patients with an increase in SBP >/= 10mm Hg during HD (IDH); 
      group 2 -patients with SBP decrease of greater >/=10mm Hg during HD; group 3 - 
      patients with SBP increase or decrease by < 10mm Hg during HD. LVM index (LVMI) 
      was measured using cardiac MRI, which were centrally read. Baseline 
      characteristics were compared in the 3 groups and multivariable regression models 
      were fitted for the adjusted association of IDH with LVMI. RESULTS: Among the 80 
      participants, 7 (8.8%) had IDH and had average Delta SBP 17.0 +/- 10.1 mmHg during HD. 
      Patients with IDH were less likely to be diabetic, had lower pre-dialysis SBP and 
      lower percent interdialytic weight gain as compared to the other 2 groups 
      (p=0.02, p< 0.001 and p=0.02 respectively). In multivariable regression analyses, 
      IDH was significantly associated with LVMI (adjusted mean difference relative to 
      SBP decreased group [95% confidence interval (CI)] = 12.5 [3.6, 21.5], p=0.01) 
      after adjusting for age, sex, diabetes, IDWG%, pre-HD SBP and beta blocker use. 
      Every 1 mm rise in DeltaSBP during HD was associated with 0.2 g/m2 increase in LVMI 
      in adjusted models (p=0.04). CONCLUSION: IDH is independently associated with 
      higher LVMI in hypertensive HD patients and may contribute to increased 
      cardiovascular events.
CI  - (c) 2018 The Author(s). Published by S. Karger AG, Basel.
FAU - Shamir, Amith Roy
AU  - Shamir AR
AD  - Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh, 
      Pittsburgh, Pennsylvania, USA.
FAU - Karembelkar, Ameet
AU  - Karembelkar A
AD  - Private Nephrology Practice, Pittsburgh, Pennsylvania, USA.
FAU - Yabes, Jonathan
AU  - Yabes J
AD  - Center for Research on Heath Care, Division of General Internal Medicine, 
      Department of Medicine and Biostatistics, University of Pittsburgh, Pittsburgh, 
      Pennsylvania, USA.
FAU - Yao, Yi
AU  - Yao Y
AD  - Center for Research on Heath Care, Division of General Internal Medicine, 
      Department of Medicine and Biostatistics, University of Pittsburgh, Pittsburgh, 
      Pennsylvania, USA.
FAU - Miskulin, Dana
AU  - Miskulin D
AD  - Nephrology Division, Department of Medicine, Tufts University, Boston, 
      Massachusetts, USA.
FAU - Gassman, Jennifer
AU  - Gassman J
AD  - Quantitative Health Sciences Department, Cleveland Clinic, Cleveland, Ohio, USA.
FAU - Ploth, David
AU  - Ploth D
AD  - Nephrology Division, Department of Medicine, Medical University of South 
      Carolina, Charleston, South Carolina, USA.
FAU - Negrea, Lavinia
AU  - Negrea L
AD  - Nephrology and Hypertension Division, Department of Medicine, Case Western 
      Reserve University, Cleveland, Ohio, USA.
FAU - Paine, Susan
AU  - Paine S
AD  - Dialysis Clinic, Inc., New Mexico, New Mexico, USA.
FAU - Rahman, Mahboob
AU  - Rahman M
AD  - Nephrology and Hypertension Division, Department of Medicine, Case Western 
      Reserve University, Cleveland, Ohio, USA.
FAU - Kwong, Raymond Y
AU  - Kwong RY
AD  - Cardiovascular Division, Department of Medicine, Harvard Medical School, Boston, 
      Massachusetts, USA.
FAU - Zager, Philip
AU  - Zager P
AD  - Dialysis Clinic, Inc., New Mexico, New Mexico, USA.
AD  - Nephrology Division, Department of Medicine, University of New Mexico, New 
      Mexico, New Mexico, USA.
FAU - Jhamb, Manisha
AU  - Jhamb M
AD  - Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh, 
      Pittsburgh, Pennsylvania, USA, jhambm@upmc.edu.
LA  - eng
GR  - P30 DK079307/DK/NIDDK NIH HHS/United States
GR  - R01 DK083424/DK/NIDDK NIH HHS/United States
PT  - Journal Article
DEP - 20180530
PL  - Switzerland
TA  - Kidney Blood Press Res
JT  - Kidney & blood pressure research
JID - 9610505
SB  - IM
MH  - Adult
MH  - Aged
MH  - Blood Pressure
MH  - Cardiovascular Diseases/diagnostic imaging/*etiology
MH  - Cross-Sectional Studies
MH  - Female
MH  - Humans
MH  - Hypertension/*complications
MH  - Hypertrophy, Left Ventricular/*complications
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Renal Dialysis/*adverse effects
MH  - Renal Insufficiency, Chronic/therapy
PMC - PMC6487648
MID - NIHMS1021790
OTO - NOTNLM
OT  - Hemodialysis
OT  - Intradialytic hypertension
OT  - Left ventricular mass
EDAT- 2018/06/06 06:00
MHDA- 2018/10/23 06:00
PMCR- 2019/04/29
CRDT- 2018/06/06 06:00
PHST- 2017/09/29 00:00 [received]
PHST- 2018/05/24 00:00 [accepted]
PHST- 2018/06/06 06:00 [pubmed]
PHST- 2018/10/23 06:00 [medline]
PHST- 2018/06/06 06:00 [entrez]
PHST- 2019/04/29 00:00 [pmc-release]
AID - 000490336 [pii]
AID - 10.1159/000490336 [doi]
PST - ppublish
SO  - Kidney Blood Press Res. 2018;43(3):882-892. doi: 10.1159/000490336. Epub 2018 May 
      30.