Assessment of blood pressure in hemodialysis patients

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

It is self-evident that accurate measurement of blood pressure (BP) is essential for the diagnosis and treatment of hypertension. Patients on hemodialysis typically do not have their BP measured under standardized conditions, a source of error in the assessment of their BP. However, their are some unique sources of error involving interdialytic weight gain, occurrence of sleep apnea and consequent nocturnal hypertension, inability to take BP in both arms in patients who have hemodialysis angioaccess in the arm, and the white coat effect in these patients as well. Precise measurement of BP in hemodialysis patients requires interdialytic ambulatory BP monitoring. However, when ambulatory BP monitoring is not possible, BP obtained in the dialysis unit can be used in a qualitative sense for prediction of hypertension in these patients. A 2-week average predialysis BP of greater than 150/85 mmHg or a postdialysis BP of greater than 130/75 mmHg has at least 80% sensitivity in diagnosing hypertension. Specificity of at least 80% can be achieved if predialysis BP of greater than 160/90 mmHg or postdialysis BP of greater than 140/80 mmHg are used. However, poor agreement between hemodialysis unit BP and ambulatory BP precludes their use for the precise prediction of BP. Improving measurement techniques in the dialysis unit, averaging multiple BP values, using 20-minute postdialysis readings, or home BP monitoring can improve BP determination when interdialytic BP monitoring is not possible.

Original languageEnglish
Pages (from-to)299-304
Number of pages6
JournalSeminars in Dialysis
Volume15
Issue number5
DOIs
StatePublished - Sep 2002

Fingerprint

Renal Dialysis
Blood Pressure
Ambulatory Blood Pressure Monitoring
Hypertension
Dialysis
Research Design
Blood Pressure Determination
Sleep Apnea Syndromes
Weight Gain
Reading

ASJC Scopus subject areas

  • Nephrology

Cite this

Assessment of blood pressure in hemodialysis patients. / Agarwal, Rajiv.

In: Seminars in Dialysis, Vol. 15, No. 5, 09.2002, p. 299-304.

Research output: Contribution to journalArticle

@article{a36edd5c5ad641df8a646fe3a9ba9492,
title = "Assessment of blood pressure in hemodialysis patients",
abstract = "It is self-evident that accurate measurement of blood pressure (BP) is essential for the diagnosis and treatment of hypertension. Patients on hemodialysis typically do not have their BP measured under standardized conditions, a source of error in the assessment of their BP. However, their are some unique sources of error involving interdialytic weight gain, occurrence of sleep apnea and consequent nocturnal hypertension, inability to take BP in both arms in patients who have hemodialysis angioaccess in the arm, and the white coat effect in these patients as well. Precise measurement of BP in hemodialysis patients requires interdialytic ambulatory BP monitoring. However, when ambulatory BP monitoring is not possible, BP obtained in the dialysis unit can be used in a qualitative sense for prediction of hypertension in these patients. A 2-week average predialysis BP of greater than 150/85 mmHg or a postdialysis BP of greater than 130/75 mmHg has at least 80{\%} sensitivity in diagnosing hypertension. Specificity of at least 80{\%} can be achieved if predialysis BP of greater than 160/90 mmHg or postdialysis BP of greater than 140/80 mmHg are used. However, poor agreement between hemodialysis unit BP and ambulatory BP precludes their use for the precise prediction of BP. Improving measurement techniques in the dialysis unit, averaging multiple BP values, using 20-minute postdialysis readings, or home BP monitoring can improve BP determination when interdialytic BP monitoring is not possible.",
author = "Rajiv Agarwal",
year = "2002",
month = "9",
doi = "10.1046/j.1525-139X.2002.00074.x",
language = "English",
volume = "15",
pages = "299--304",
journal = "Seminars in Dialysis",
issn = "0894-0959",
publisher = "Wiley-Blackwell",
number = "5",

}

TY - JOUR

T1 - Assessment of blood pressure in hemodialysis patients

AU - Agarwal, Rajiv

PY - 2002/9

Y1 - 2002/9

N2 - It is self-evident that accurate measurement of blood pressure (BP) is essential for the diagnosis and treatment of hypertension. Patients on hemodialysis typically do not have their BP measured under standardized conditions, a source of error in the assessment of their BP. However, their are some unique sources of error involving interdialytic weight gain, occurrence of sleep apnea and consequent nocturnal hypertension, inability to take BP in both arms in patients who have hemodialysis angioaccess in the arm, and the white coat effect in these patients as well. Precise measurement of BP in hemodialysis patients requires interdialytic ambulatory BP monitoring. However, when ambulatory BP monitoring is not possible, BP obtained in the dialysis unit can be used in a qualitative sense for prediction of hypertension in these patients. A 2-week average predialysis BP of greater than 150/85 mmHg or a postdialysis BP of greater than 130/75 mmHg has at least 80% sensitivity in diagnosing hypertension. Specificity of at least 80% can be achieved if predialysis BP of greater than 160/90 mmHg or postdialysis BP of greater than 140/80 mmHg are used. However, poor agreement between hemodialysis unit BP and ambulatory BP precludes their use for the precise prediction of BP. Improving measurement techniques in the dialysis unit, averaging multiple BP values, using 20-minute postdialysis readings, or home BP monitoring can improve BP determination when interdialytic BP monitoring is not possible.

AB - It is self-evident that accurate measurement of blood pressure (BP) is essential for the diagnosis and treatment of hypertension. Patients on hemodialysis typically do not have their BP measured under standardized conditions, a source of error in the assessment of their BP. However, their are some unique sources of error involving interdialytic weight gain, occurrence of sleep apnea and consequent nocturnal hypertension, inability to take BP in both arms in patients who have hemodialysis angioaccess in the arm, and the white coat effect in these patients as well. Precise measurement of BP in hemodialysis patients requires interdialytic ambulatory BP monitoring. However, when ambulatory BP monitoring is not possible, BP obtained in the dialysis unit can be used in a qualitative sense for prediction of hypertension in these patients. A 2-week average predialysis BP of greater than 150/85 mmHg or a postdialysis BP of greater than 130/75 mmHg has at least 80% sensitivity in diagnosing hypertension. Specificity of at least 80% can be achieved if predialysis BP of greater than 160/90 mmHg or postdialysis BP of greater than 140/80 mmHg are used. However, poor agreement between hemodialysis unit BP and ambulatory BP precludes their use for the precise prediction of BP. Improving measurement techniques in the dialysis unit, averaging multiple BP values, using 20-minute postdialysis readings, or home BP monitoring can improve BP determination when interdialytic BP monitoring is not possible.

UR - http://www.scopus.com/inward/record.url?scp=0036718929&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036718929&partnerID=8YFLogxK

U2 - 10.1046/j.1525-139X.2002.00074.x

DO - 10.1046/j.1525-139X.2002.00074.x

M3 - Article

C2 - 12358628

AN - SCOPUS:0036718929

VL - 15

SP - 299

EP - 304

JO - Seminars in Dialysis

JF - Seminars in Dialysis

SN - 0894-0959

IS - 5

ER -