SP636VARIABILITY OF BLOOD PRESSURE ALONG DIALYSIS: RELATION WITH MORTALITY

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INTRODUCTION AND AIMS: Recent studies, link hemodialysis systolic blood pressure variability (BPV) and mortality . However BPV can be seen with different blood pressure (BP) components, including systolic and diastolic as well as predialysis, intradialytic, and postdialysis BP. AIMS: To analyze blood pressure variability in different measurements along hemodialisys (HD) session and verify which of them predict mortality in incident patients. MATERIAL AND METHODS: Retrospective analysis of 277 incidents patients on conventional HD. Systolic and diastolic BP records were collected before and after hemodialysis in the first 6 months from the beginning of treatment. BPV was calculated using the coefficient of variation (CV). Demographic and clinical data were analyzed during a 24 month follow-up period as well as mortality rate. Survival analisys (Cox proportional hazards) was carried out by stratifying patients in tertiles of BP variability. RESULTS: 277 incident HD patiens (186 M, 91 F). Age (yr): 65,1 ± 13,1. Sex (%men): 67,1. Diabetes (%): 45,8. Hypertension (%): 95. Systolic preHD BP (mmHg): 137,6 ± 14,5 CV: 11,5 ± 3,7, Diastolic preHD BP (mmHg): 73,3 ± 6,8. CV:12,1 ± 7,7. Systolic postHD BP(mmHg) : 137,2 ± 14,7. CV: 11,2 ± 3,05. Diastolic postHD BP: 73,5 ± 6,5. CV: 13,5 ± 14,5. We observed 51 deaths (18,4%) during the follow-up period. Higher Diastolic post hemodialisys blood pressure variability (DBPV) was associated with an increased risk of death, as shown in the table below. Survival analysis using Kaplan-Meyer shows significative differences between tertiles of DBPV (p<0.009). CONCLUSIONS: In our study we observed and increased risk of mortality in hemodialysis patiens with higher DBPV. We did not observe this increase in mortality in other analyzed parameters.

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