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イチハラ アツヒロ
ICHIHARA Atsuhiro
市原 淳弘 所属 医学部 医学科（東京女子医科大学病院） 職種 教授・基幹分野長 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Characteristics of month-by-month blood pressure variability in patients on hemodialysis. |
| 掲載誌名 | 正式名：Kidney & blood pressure research 略 称：Kidney Blood Press Res ISSNコード：14230143/14204096 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 48,pp.761-776 |
| 著者・共著者 | Amari Yoshifumi†, Morimoto Satoshi*, Yurugi Takatomi, Oyama Yasuo, Nakajima Fumitaka, Shimizu Satoru, Ichihara Atsuhiro |
| 担当区分 | 最終著者 |
| 発行年月 | 2023/11 |
| 概要 | INTRODUCTION:Poor prognosis in hemodialysis patients is due to the increased prevalence of cardiovascular diseases among them. We previously reported that higher visit-by-visit blood pressure variability is associated with increased cardiovascular mortality in hemodialysis patients. This present study aimed to investigate the characteristics of month-by-month blood pressure variability in these patients.METHODS:A total of 324 maintenance hemodialysis patients, who could be followed up for 60 months, were recruited. We used standard deviation (SD), coefficient of variation (CV), and variation independent of the mean (VIM) in pre- and post-dialysis systolic blood pressure (pre- and post-SD, pre- and post-CV and pre- and post-VIM) as an index of month-by-month blood pressure variability (MMBPV). We investigated (1) the reproducibility of month-by-month blood pressure variability, (2) relationship between these values and background factors, and (3) association between these values and mortality.RESULTS:MMBPV (pre- and post-SD, pre- and post-CV and pre- and post-VIM) showed significant reproducibility [intraclass correlation, 0.483 (P <0.001), 0.553 (P <0.001), 0.450 (P <0.001), 0.518 (P <0.001), 0.456 (P <0.001) and 0.522 (P <0.001), respectively]. High pre-VIM was associated with high interdialytic weight gain and poor nutritional status. High post-VIM was associated with glucose intolerance, high interdialytic weight gain, and poor nutritional status and associated with high rate of cardiovascular deaths independent of other factors (hazard ratio: 1.104, 95% confidence interval: 1.011-1.207, P = 0.028).CONCLUSION:These data suggested that pre- and post-VIM in hemodialysis patients is reproducible and associated with various background factors, and especially post-VIM is independently correlated with cardiovascular mortality. Further studies are necessary to confirm the mechanism of increased post-VIM and clarify whether reducing post-VIM can improve the prognosis of |
| DOI | 10.1159/000534967 |
| PMID | 37926094 |