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Perit Dial Int 23(1): 46-52 2003
© 2003 International Society for Peritoneal Dialysis
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Peritoneal Dialysis International, Vol 23, Issue 1, 46-52
Copyright © 2003 by International Society for Peritoneal Dialysis

Articles

The association of peritoneal transport properties with 24-hour blood pressure levels in CAPD patients

Z Tonbul, L Altintepe, C Sozlu, M Yeksan, A Yildiz, and S Turk

Division of Nephrology, Department of Internal Medicine, Selcuk University Medical School, Konya, Turkey.

OBJECTIVES: We aimed to investigate the effects of peritoneal transport characteristics on blood pressure (BP) parameters, measured by 24-hour ambulatory blood pressure monitoring (ABPM), and on the development of left ventricular hypertrophy (LVH) in continuous ambulatory peritoneal dialysis (CAPD) patients. DESIGN: Cross-sectional and prospective design. SETTING: Tertiary-care center. PATIENTS: 25 CAPD patients (11 male, 14 female; mean age 47 +/- 14 years) were included. Mean time on CAPD was 22.9 +/- 18 months and all patients had been dialyzed for more than 6 months. The patients were divided into high, high-average, low-average, and low transport groups according to peritoneal equilibration test results. MAIN OUTCOME MEASURES: Daytime and nighttime systolic and diastolic BP and left ventricular mass index among the different peritoneal transport groups; changes in BP parameters before and after increase in ultrafiltration. RESULTS: On 24-hour ABPM records, 13 patients (52%) were found to be hypertensive. Both mean systolic and diastolic BP were significantly increased in high-transporter groups compared to low transporters in both daytime and nighttime BP parameters. Left ventricular mass index was higher in high transporters compared to low transporters, without reaching statistical significance: 160 +/- 23 vs 119 +/- 41 g/m2, p > 0.05. Following increase in ultrafiltration, mean systolic (145 +/- 13 vs 128 +/- 5 mmHg, p < 0.001) and diastolic (96 +/- 10 vs 81 +/- 3 mmHg, p < 0.001) BP decreased, and BP levels returned to normotensive levels in 6 (46%) of the 13 hypertensive patients, requiring discontinuation of antihypertensive drugs. CONCLUSION: Improvement in volume status resulted in a decrease in both daytime and nighttime BP. Differences in peritoneal transport properties were associated with the development of hypertension and LVH.




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K. J. Wiggins, S. P. McDonald, F. G. Brown, J. B. Rosman, and D. W. Johnson
High membrane transport status on peritoneal dialysis is not associated with reduced survival following transfer to haemodialysis
Nephrol. Dial. Transplant., October 1, 2007; 22(10): 3005 - 3012.
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