Jennifer E Flythe1, Steven M Brunelli. 1. aDivision of Nephrology and Hypertension, Department of Medicine, UNC School of Medicine, University of North Carolina Kidney Center, Chapel Hill, North Carolina bDaVita Clinical Research, Minneapolis, Minnesota, USA.
Abstract
PURPOSE OF REVIEW: This review focuses on recent evidence linking blood pressure variability (BPV) to adverse clinical outcomes in the chronic hemodialysis patient population. RECENT FINDINGS: BPV is an increasingly recognized poor prognostic factor in the general population. A growing body of evidence suggests that both short-term and long-term BPV are associated with adverse events among chronic dialysis patients. Over the last 18 months, several studies have linked long-term BPV (considered dialysis treatment to dialysis treatment) to all-cause and cardiovascular morbidity and mortality. Similar results have been demonstrated for short-term (considered as intradialytic) BPV and clinical outcomes. Further studies substantiating these findings and examining potential BPV mitigation strategies are needed. Additionally, a BPV metric that is easily calculated and tracked in the clinical setting is necessary before BPV can become a routine component of clinical monitoring. SUMMARY: Recent observational data demonstrate an association between short-term and long-term BPV and adverse outcomes among chronic hemodialysis patients. Further research is needed to identify strategies that mitigate this risk and to translate these findings into clinical practice.
PURPOSE OF REVIEW: This review focuses on recent evidence linking blood pressure variability (BPV) to adverse clinical outcomes in the chronic hemodialysis patient population. RECENT FINDINGS: BPV is an increasingly recognized poor prognostic factor in the general population. A growing body of evidence suggests that both short-term and long-term BPV are associated with adverse events among chronic dialysis patients. Over the last 18 months, several studies have linked long-term BPV (considered dialysis treatment to dialysis treatment) to all-cause and cardiovascular morbidity and mortality. Similar results have been demonstrated for short-term (considered as intradialytic) BPV and clinical outcomes. Further studies substantiating these findings and examining potential BPV mitigation strategies are needed. Additionally, a BPV metric that is easily calculated and tracked in the clinical setting is necessary before BPV can become a routine component of clinical monitoring. SUMMARY: Recent observational data demonstrate an association between short-term and long-term BPV and adverse outcomes among chronic hemodialysis patients. Further research is needed to identify strategies that mitigate this risk and to translate these findings into clinical practice.
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