Ambulatory Blood Pressure Monitoring During 52 Hours in Patients With Chronic Kidney Disease and Haemodialysis Treatment-An Exploratory Pilot Study.
Jenny Stenberg, Oskar Sandberg, Kerstin Marttala and 1 others
PMID 39905984WHAT IT FOUND
BP during dialysis was higher after a long break than a short break in 11 haemodialysis patients.
Night BP did not drop on the second inter-dialytic night, and the 52-hour monitor was tolerated by all but one.
Key findings
01Mean systolic BP during dialysis was 122 mmHg after a long inter-dialytic interval and 114 mmHg after a short one (p = 0.012), and mean diastolic BP was 62 mmHg and 61 mmHg (p = 0.036).
02All participants except one tolerated having the ambulatory BP monitor on for the planned period.
03During the first inter-dialytic night, median systolic BP dropped from 130 to 116 mmHg and median diastolic BP from 71 to 66 mmHg, but neither change was statistically significant; during the second night BP did not drop and the change was not significant.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 11 patients were studied, so the results are exploratory and could easily be due to chance. Patients were selected purposively based on clinic recommendations and presumed motivation, which may have introduced selection bias. Dialysis schedules varied: only eight of 11 patients had the same frequency, so the findings may not apply to all haemodialysis patients. Many statistical tests were done without adjustment for multiple testing, increasing the risk of false-positive findings. The ambulatory BP device had limited prior validation, so the accuracy of the measurements is not established. The inter-dialytic observation period was limited to 44 hours, and the study did not investigate why BP differed after long versus short intervals. The study was non-interventional, so it does not show that changing dialysis timing or monitoring improves outcomes.
Declared interests
The authors declared no conflicts of interest. No funding source is reported.
The easy way to misread this
Do not conclude that longer dialysis breaks cause higher BP or that ambulatory BP monitoring improves outcomes. This was a non-interventional pilot in 11 purposively selected patients, with many unadjusted tests and limited device validation. The study did not test whether changing dialysis timing or monitoring improves outcomes.