Prognostic Value of Central and BracHial Ambulatory Blood Pressure Monitoring in ERSD Patients Treated With HeMOdialysis

Study Overview
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Brief Summary
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This is a prospective cohort study which aims to explore the significance of brachial and central ambulatory blood pressure monitoring in predicting cardiovascular risk in patients with end stage renal disease who are treated with hemodialysis. Enrolled patients will receive a 48-hour central and brachial ambulatory blood pressure monitoring at its first-time dialysis after enrollment. And their cardiovascular events and deaths at first and third year will be followed-up.

Detailed Description
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The protocol of this study was approved by the local ethical review board. The including criteria: 1) ESRD treated with hemodialysis for more than 3 months prior to study enrollment; 2) agree to participate the study and sign informed written consent; 3) available for long-term follow-up. The excluding criteria: 1)chronic atrial fibrillation or other cardiac arrhythmia; 2) nonfunctional arteriovenous fistula in the contralateral brachial area of the one used for dialysis; 3) myocardial infarction, angina pectoris and ischemic stroke during the previous month; 4) congestive heart failure class IV based on the New York Heart Association classification; 5) malignancy or any other condition with poor prognosis; 6) antihypertensive treatment during one month prior to enrollment. After enrollment, every patient will receive a question-based interview to obtain medical history and the following examinations and tests: anthropometric parameters measurement including body height, weight; biochemical tests including vein blood and urine. At the first-time dialysis after enrollment, patients will receive 48-hour central and brachial ambulatory blood pressure monitoring using a well validated and commercial device Mobil-O-Graph (IEM, Germany). Brachial blood pressure are measured for each patient before every dialysis for at three month. Then one-year and three-year cardiovascular events and deaths will be followed-up. The primary outcome measures are as follows: deaths and cardiovascular events including nonfatal myocardial infarction, unstable angina, stroke, hospitalization for heart failure, or resuscitated cardiac arrest.

Official Title
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Prognostic Value of Central and BracHial Ambulatory Blood Pressure Monitoring in ERSD Patients Treated With HeMOdialysis: the C-HEMO Study

Conditions
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End Stage Renal Disease

Intervention / Treatment
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* Other: 48-hour blood pressure ambulatory monitoring


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients with end-stage renal disease treated with hemodialysis for more than 3 months prior to study enrollment; agree to participate the study and sign informed written consent; available for long-term follow-up. Exclusion Criteria: chronic atrial fibrillation or other cardiac arrhythmia; nonfunctional arteriovenous fistula in the contralateral brachial area of the one used for dialysis; myocardial infarction, angina pectoris and ischemic stroke during the previous month; congestive heart failure class IV based on the New York Heart Association classification; malignancy or any other condition with poor prognosis; antihypertensive treatment during 1 month prior to enrollment.
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: 48-hour blood pressure ambulatory monitoring|at first-time dialysis after enrollment, each patient will receive brachial and central blood pressure monitoring for 48 hours using a validate and commercially available device Mobil-O-Graph (IEM, Germany).|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cardiovascular events | nonfatal myocardial infarction, unstable angina, stroke, hospitalization for heart failure, or resuscitated cardiac arrest | 3 year | 
| cardiovascular deaths | cardiovascular deaths | 3 year | 
| all-cause deaths | all-cause deaths | 3 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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central blood pressure, ambulatory blood pressure monitoring, blood pressure variability