Duo Lyu1,2, Xishao Xie1, Xiaohui Zhang1, Jianghua Chen1. 1. Kidney Disease Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China. 2. Clinical Pharmacy Research Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Abstract
OBJECTIVE: To investigate the associations between mean arterial pressure (MAP) and mortality in patients with peritoneal dialysis (PD). METHODS: A total of 1737 patients with terminal renal diseases under PD in the First Affiliated Hospital of Zhejiang University from 2008 to 2016 were enrolled. Patients were followed up for 33.0(19.3, 52.4) months. The mean arterial pressure over the first 3 months of PD therapy were calculated. All-cause death and cardiovascular death were assessed using Cox regression models adjusted for demographics, laboratory measurements, comorbid conditions and antihypertensive medications. RESULTS: During the follow-up, 208 patients died, among which 95(45.7%) patients died of cardiovascular causes. Compared with patients with MAP >95-<120 mmHg, patients with MAP ≤ 95 mmHg were associated with significantly higher risk of all-cause death (HR=1.40,95%CI:1.01-1.93,P<0.05); patients with MAP ≥ 120 mmHg were associated with significantly higher risk of all-cause (HR=2.12,95%CI:1.32-3.40, P<0.01) and cardiovascular morality (HR=2.55, 95%CI:1.38-4.70, P<0.01). MAP presents a U-shaped association with all-cause mortality and a J-shaped association with cardiovascular mortality. CONCLUSIONS: Both high MAP and low MAP are associated with higher risk of mortality in PD patients.
OBJECTIVE: To investigate the associations between mean arterial pressure (MAP) and mortality in patients with peritoneal dialysis (PD). METHODS: A total of 1737 patients with terminal renal diseases under PD in the First Affiliated Hospital of Zhejiang University from 2008 to 2016 were enrolled. Patients were followed up for 33.0(19.3, 52.4) months. The mean arterial pressure over the first 3 months of PD therapy were calculated. All-cause death and cardiovascular death were assessed using Cox regression models adjusted for demographics, laboratory measurements, comorbid conditions and antihypertensive medications. RESULTS: During the follow-up, 208 patients died, among which 95(45.7%) patients died of cardiovascular causes. Compared with patients with MAP >95-<120 mmHg, patients with MAP ≤ 95 mmHg were associated with significantly higher risk of all-cause death (HR=1.40,95%CI:1.01-1.93,P<0.05); patients with MAP ≥ 120 mmHg were associated with significantly higher risk of all-cause (HR=2.12,95%CI:1.32-3.40, P<0.01) and cardiovascular morality (HR=2.55, 95%CI:1.38-4.70, P<0.01). MAP presents a U-shaped association with all-cause mortality and a J-shaped association with cardiovascular mortality. CONCLUSIONS: Both high MAP and low MAP are associated with higher risk of mortality in PD patients.
Authors: Pierre Boutouyrie; Danilo Fliser; David Goldsmith; Adrian Covic; Andrzej Wiecek; Alberto Ortiz; Alberto Martinez-Castelao; Bengt Lindholm; Ziad A Massy; Gultekin Suleymanlar; Rosa Sicari; Luna Gargani; Gianfranco Parati; Francesca Mallamaci; Carmine Zoccali; Gerard M London Journal: Nephrol Dial Transplant Date: 2013-09-30 Impact factor: 5.992
Authors: Udaya P Udayaraj; Retha Steenkamp; Fergus J Caskey; Chris Rogers; Dorothea Nitsch; David Ansell; Charles R V Tomson Journal: Am J Kidney Dis Date: 2008-11-22 Impact factor: 8.860