Factors Associated With Interdialytic Blood Pressure Variability in Maintenance Hemodialysis Patients

Study Overview
=================
Brief Summary
-----------------
The purpose of this study is to explore the factors associated with interdialytic blood pressure variability in maintenance hemodialysis patients, especially the association between volume status and blood pressure variability.

Detailed Description
-----------------
Hemodialysis patients experience higher rates of cardiovascular morbidity and mortality than the general population and many populations with other chronic diseases. This exceptional risk is explained in part by known risk factors such as diabetes, hypertension, and other uremia-related factors, including vascular calcification and stiffness, autonomic dysfunction, and a high burden of circulating inflammatory mediators. However, additional unidentified risk factors also likely contribute to the disproportionately high prevalence of cardiovascular morbidity in hemodialysis patients. Blood pressure variability may represent one plausible cardiovascular risk factor. Data from nonuremic human populations show an association between greater blood pressure variability and cardiovascular events,nonfatal cardiovascular events,stroke,and increased left ventricular mass. There has been comparatively little work examining the causes and effects of blood pressure variability in hemodialysis populations. So the purpose of this study is to explore the factors associated with interdialytic blood pressure variability in maintenance hemodialysis patients, especially the association between volume status and blood pressure variability.

Official Title
-----------------
Factors Associated With Interdialytic Blood Pressure Variability in Maintenance Hemodialysis Patients

Conditions
-----------------
Kidney Failure, Chronic

Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: age 18 years or older receipt of thrice-weekly in-center hemodialysis no anticipation of imminent(<6 months)living related kidney transplant not transfer of care to a nonparticipating facility no dialytic modality change free of vascular, infectious, or bleeding complication within 1 month Exclusion Criteria: who missed >2 hemodialysis treatments over 1 month abused drugs severe anemia，malnutrition，chronic atrial fibrillation body mass index of 40 >kg/m2

Ages Eligible for Study
-----------------
Minimum Age: 24 Years
Maximum Age: 85 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| volume status<br>volume status:group1 over volume status,group2 normal volume status,group3 low volume status | |
| night blood pressure<br>night blood pressure：group1 nondipper,group2 dipper,group3 extreme dipper,group4 riser | |
| interdialysis weight gain<br>interdialysis weight gain:group1 >5% dry weight,group2 <5% dry weight | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| interdialytic blood pressure | Ambulatory BP monitoring was performed after the midweek hemodialysis session for 44 hours. Ambulatory BPs were recorded every 20 minutes during the day (6 AM to 10 PM) and every 30 minutes during the night (10 PM to 6 AM) in the nonaccess arm, We use the coefficient of variation or standard deviation in interdialytic blood pressure as a indicator of systolic blood pressure variability. | 44 hours | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
hemodialysis, blood pressure variability, volume status