Blood pressure control with active ultrafiltration measures and without antihypertensives is essential for survival in hemodiafiltration and hemodialysis programs for patients with CKD: a prospective observational study
Abstract Background High blood pressure is a prevalent condition in patients with chronic kidney disease on hemodialysis. Adequate control of high blood pressure is essential to reducing deaths in this group. The present study aimed to observe mortality prospectively in a group of patients in hemodi...
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2025-01-01
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| Online Access: | https://doi.org/10.1186/s12882-025-03948-0 |
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| author | Franklin Geovany Mora-Bravo Pamela Tatiana Morales Torres Nelson Rojas Campoverde Guillermina Lucía Blum Carcelen Juan Cristobal Santacruz Mancheno Ángel Cristóbal Santacruz Tipanta Hector Perez-Grovas Willan Patricio Robles Abarca |
| author_facet | Franklin Geovany Mora-Bravo Pamela Tatiana Morales Torres Nelson Rojas Campoverde Guillermina Lucía Blum Carcelen Juan Cristobal Santacruz Mancheno Ángel Cristóbal Santacruz Tipanta Hector Perez-Grovas Willan Patricio Robles Abarca |
| author_sort | Franklin Geovany Mora-Bravo |
| collection | DOAJ |
| description | Abstract Background High blood pressure is a prevalent condition in patients with chronic kidney disease on hemodialysis. Adequate control of high blood pressure is essential to reducing deaths in this group. The present study aimed to observe mortality prospectively in a group of patients in hemodialysis and hemodiafiltration programs in whom the use of antihypertensives was optimized with the point-of-care dry weight (POC-DW) technique. Methods The present observational, prospective study was carried out at the Pafram hemodiafiltration unit in Morona Santiago, Ecuador, and the hemodialysis unit of the Fundación Renal del Ecuador in Guayaquil, Ecuador, from August 2019 to December 2023. Patients who were receiving hemodiafiltration were included. Weight was optimized with POC-DW for eight weeks. In Group 1, patients whose use of antihypertensive drugs was not required to control systolic blood pressure with a value less than 150 mmHg predialysis, less than 130 mmHg postdialysis, and a peridialytic blood pressure (defined as post-HD minus pre-HD SBP) between 0 and − 20 mmHg were analyzed. In Group 2, patients who required antihypertensive drugs for not meeting the aims of systolic blood pressure were included. The variables included clinical, demographic, mortality, description of the treatment, and routine laboratory tests in dialysis programs. The sample was nonprobabilistic. Survival analysis was performed for the study groups. The log-rank test (Mantel-Cox) was used for survival comparisons. Results The study included 106 patients. Optimal blood pressure control without antihypertensive treatment was achieved in 52 patients (49.1%) (Group 1). In 54 patients (50.9%), antihypertensive agents were required (Group 2). There was more significant mortality in the group that received antihypertensives: 11 patients in group 1 (21.2%) versus 25 patients in group 2 (46.3%) (P = 0.005). Survival was more significant in group 1, with an HR of 2.2163 (1.125–4.158) (P = 0.0243). Conclusion In hemodiafiltration and hemodialysis programs, blood pressure control with active ultrafiltration measures and without using antihypertensives is essential for survival in patients with CKD. |
| format | Article |
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| institution | Kabale University |
| issn | 1471-2369 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Nephrology |
| spelling | doaj-art-db946c5fb08a4a4694593e71c6a5eff12025-01-19T12:13:32ZengBMCBMC Nephrology1471-23692025-01-0126111110.1186/s12882-025-03948-0Blood pressure control with active ultrafiltration measures and without antihypertensives is essential for survival in hemodiafiltration and hemodialysis programs for patients with CKD: a prospective observational studyFranklin Geovany Mora-Bravo0Pamela Tatiana Morales Torres1Nelson Rojas Campoverde2Guillermina Lucía Blum Carcelen3Juan Cristobal Santacruz Mancheno4Ángel Cristóbal Santacruz Tipanta5Hector Perez-Grovas6Willan Patricio Robles Abarca7Pafram Hemodiafiltration Unit, Complementary Health NetworkPafram Hemodiafiltration Unit, Complementary Health NetworkHemodialysis Unit of the Renal Foundation of Ecuador in GuayaquilHemodialysis Unit of the Renal Foundation of Ecuador in GuayaquilMenydial Kidney ClinicPafram Hemodiafiltration Unit, Complementary Health NetworkNephrology Service, Instituto Nacional de Cardiología Ignacio ChavezMedical career, Faculty of Health Sciences, Universidad Técnica de AmbatoAbstract Background High blood pressure is a prevalent condition in patients with chronic kidney disease on hemodialysis. Adequate control of high blood pressure is essential to reducing deaths in this group. The present study aimed to observe mortality prospectively in a group of patients in hemodialysis and hemodiafiltration programs in whom the use of antihypertensives was optimized with the point-of-care dry weight (POC-DW) technique. Methods The present observational, prospective study was carried out at the Pafram hemodiafiltration unit in Morona Santiago, Ecuador, and the hemodialysis unit of the Fundación Renal del Ecuador in Guayaquil, Ecuador, from August 2019 to December 2023. Patients who were receiving hemodiafiltration were included. Weight was optimized with POC-DW for eight weeks. In Group 1, patients whose use of antihypertensive drugs was not required to control systolic blood pressure with a value less than 150 mmHg predialysis, less than 130 mmHg postdialysis, and a peridialytic blood pressure (defined as post-HD minus pre-HD SBP) between 0 and − 20 mmHg were analyzed. In Group 2, patients who required antihypertensive drugs for not meeting the aims of systolic blood pressure were included. The variables included clinical, demographic, mortality, description of the treatment, and routine laboratory tests in dialysis programs. The sample was nonprobabilistic. Survival analysis was performed for the study groups. The log-rank test (Mantel-Cox) was used for survival comparisons. Results The study included 106 patients. Optimal blood pressure control without antihypertensive treatment was achieved in 52 patients (49.1%) (Group 1). In 54 patients (50.9%), antihypertensive agents were required (Group 2). There was more significant mortality in the group that received antihypertensives: 11 patients in group 1 (21.2%) versus 25 patients in group 2 (46.3%) (P = 0.005). Survival was more significant in group 1, with an HR of 2.2163 (1.125–4.158) (P = 0.0243). Conclusion In hemodiafiltration and hemodialysis programs, blood pressure control with active ultrafiltration measures and without using antihypertensives is essential for survival in patients with CKD.https://doi.org/10.1186/s12882-025-03948-0AntihypertensivesHemodiafiltrationMortalityPoint of Care Dry WeightSurvival |
| spellingShingle | Franklin Geovany Mora-Bravo Pamela Tatiana Morales Torres Nelson Rojas Campoverde Guillermina Lucía Blum Carcelen Juan Cristobal Santacruz Mancheno Ángel Cristóbal Santacruz Tipanta Hector Perez-Grovas Willan Patricio Robles Abarca Blood pressure control with active ultrafiltration measures and without antihypertensives is essential for survival in hemodiafiltration and hemodialysis programs for patients with CKD: a prospective observational study BMC Nephrology Antihypertensives Hemodiafiltration Mortality Point of Care Dry Weight Survival |
| title | Blood pressure control with active ultrafiltration measures and without antihypertensives is essential for survival in hemodiafiltration and hemodialysis programs for patients with CKD: a prospective observational study |
| title_full | Blood pressure control with active ultrafiltration measures and without antihypertensives is essential for survival in hemodiafiltration and hemodialysis programs for patients with CKD: a prospective observational study |
| title_fullStr | Blood pressure control with active ultrafiltration measures and without antihypertensives is essential for survival in hemodiafiltration and hemodialysis programs for patients with CKD: a prospective observational study |
| title_full_unstemmed | Blood pressure control with active ultrafiltration measures and without antihypertensives is essential for survival in hemodiafiltration and hemodialysis programs for patients with CKD: a prospective observational study |
| title_short | Blood pressure control with active ultrafiltration measures and without antihypertensives is essential for survival in hemodiafiltration and hemodialysis programs for patients with CKD: a prospective observational study |
| title_sort | blood pressure control with active ultrafiltration measures and without antihypertensives is essential for survival in hemodiafiltration and hemodialysis programs for patients with ckd a prospective observational study |
| topic | Antihypertensives Hemodiafiltration Mortality Point of Care Dry Weight Survival |
| url | https://doi.org/10.1186/s12882-025-03948-0 |
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