Вариабельность артериального давления у пациентов на программном гемодиализе: прогностическая значимость и возможности медикаментозной коррекции
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Tokareva A.S., Borovkova N.Yu. Blood pressure variability in hemodialysis patients: prognostic significance and treatment possibilities. Therapeutic Archive. 2020; 92 (4): 91–97. DOI: 10.26442/00403660.2020.04.000534
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Ключевые слова: гемодиализ, вариабельность артериального давления, антигипертензивная терапия, индексы вариабельности.
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A present review is devoted to the current state of the problem of blood pressure variability (BPV) in hemodialysis patients. The BPV classification and clinical significance of BPV metrics are discussed. The results of cohort and randomized studies on the high BPV influence on outcomes in hemodialysis patients, as well as on the possibilities of antihypertensive drugs in the treatment of high BPV in dialysis patients, are presented.
Keywords: hemodialysis, blood pressure variability, antihypertensive drugs, variability metrics.
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3. Mavrakanas TA, Charytan DM. Cardiovascular complications in chronic dialysis patients. Curr Opin Nephrol Hypertens. 2016;25(6):536-44. doi: 10.1097/MNH.0000000000000280
4. Quarles LD. Reducing cardiovascular mortality in chronic kidney disease: something borrowed, something new. J Clin Invest. 2013;123(2):542-3. doi: 10.1172/JCI67203
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(In Russ.)]. doi: 10.18705/1607-419X-2013-19-1-6-17
8. Flythe JE, Brunelli SM. Blood pressure variability among chronic dialysis patients: recent advances in knowledge. Curr Opin Nephrol Hypertens. 2015;24(2):163-9. doi: 10.1097/MNH.0000000000000107
9. Rothwell PM. Limitations of the usual blood-pressure hypothesis and importance of variability, instability, and episodic hypertension. Lancet. 2010;375(9718):938-48. doi: 10.1016/S0140-6736(10)60309-1
10. Kramer A, Pippias M, Noordzij M, et al. The European Renal Association – European Dialysis and Transplant Association (ERA-EDTA) Registry Annual Report 2016: a summary. Clin Kidney J. 2019;12(5):702-20. doi: 10.1093/ckj/sfz011
11. Rubinger D, Backenroth R, Sapoznikov D. Sympathetic Nervous System Function and Dysfunction in Chronic Hemodialysis Patients. Semin Dial. 2013;26(3):333-43. doi: 10.1111/sdi.12093
12. Gutiérrez-Adrianzén OA, Moraes ME, Almeida AP, et al. Pathophysiological, cardiovascular and neuroendocrine changes in hypertensive patients during the hemodialysis session. J Hum Hypertens. 2015;29(6):366-72. doi: 10.1038/jhh.2014.93
13. Karpetas A, Loutradis C, Bikos A, et al. Blood pressure variability is increasing from the first to the second day of the interdialytic interval in hemodialysis patients. J Hypertens. 2017;35(12):2517-26. doi: 10.1097/HJH.0000000000001478
14. Wang JG, Yan P, Jeffers BW. Effects of amlodipine and other classes of antihypertensive drugs on long-term blood pressure variability: evidence from randomized controlled trials. J Am Soc Hypertens. 2014;8(5):340-9. doi: 10.1016/j.jash.2014.02.004
15. Rossignol P, Cridlig J, Lehert P, et al. Visit-to-visit blood pressure variability is a strong predictor of cardiovascular events in hemodialysis: insights from FOSIDIAL. Hypertension. 2012;60(2):339-46. doi: 10.1161/HYPERTENSIONAHA.111.190397
16. Juhanoja EP, Niiranen TJ, Johansson JK, et al. Outcome-Driven Thresholds for Increased Home Blood Pressure Variability. Hypertension. 2017;69(4):599-607. doi: 10.1161/HYPERTENSIONAHA.116.08603
17. Stevens SL, Wood S, Koshiaris C, et al. Blood pressure variability and cardiovascular disease: systematic review and meta-analysis. BMJ. 2016;354:i4098. doi: 10.1136/bmj.i4098
18. Feng Y, Li Z, Liu J, et al. Association of short-term blood pressure variability with cardiovascular mortality among incident hemodialysis patients. Ren Fail. 2018;40(1):259-64. doi: 10.1080/0886022X.
2018.1456456
19. Liao R, Li J, Xiong Y, et al. Association of Peridialysis Blood Pressure and Its Variability with Cardiovascular Events in Hemodialysis Patients. Kidney Blood Press Res. 2018;43(4):1352-62. doi: 10.1159/000492595
20. Selvarajah V, Pasea L, Ojha S, et al. Pre-Dialysis Systolic Blood Pressure-Variability Is Independently Associated with All-Cause Mortality in Incident Haemodialysis Patients. PLoS One. 2014;9(1):e86514. doi: 10.1371/journal.pone.0086514
21. Norioka N, Iwata S, Yanagi S, et al. Higher visit-to-visit intra-dialytic blood pressure is associated with the progression of aortic valve stenosis in chronic hemodialysis patients. Heart Vessels. 2016;31(9):1491-6. doi: 10.1007/s00380-015-0756-z
22. Cheng Y, Zhang F, Zhu J, et al. Influence of blood pressure variability on the life of arteriovenous fistulae in maintenance hemodialysis patients. Clin Hemorheol Microcirc. 2016;62(2):129-37. doi: 10.3233/CH-151959
23. Flythe JE, Brunelli SM. Blood pressure variability and dialysis: variability may not always be the spice of life. J Am Soc Nephrol. 2014;25(4):650-3. doi: 10.1681/ASN.2013111237
24. Shafi T, Sozio SM, Bandeen-Roche K, et al. DEcIDE Network Patient Outcomes in End Stage Renal Disease Study Investigators. Predialysis Systolic BP Variability and Outcomes in Hemodialysis Patients. J Am Soc Nephrol. 2014;25(4):799-809. doi: 10.1681/ASN.2013060667
25. Umemoto S, Ogihara T, Matsuzaki M, et al. Effects of calcium channel blocker-based combinations on intra-individual blood pressure variability: post hoc analysis of the COPE trial. Hypertens Res. 2016;39(1):46-53. doi: 10.1038/hr.2015.104
26. Loutradis C, Bikos A, Raptis V, et al. Nebivolol reduces short-term blood pressure variability more potently than irbesartan in patients with intradialytic hypertension. Hypertens Res. 2019;42(7):1001-10. doi: 10.1038/s41440-018-0194-2
27. Chang TI, Flythe JE, Brunelli SM, et al. Visit-to-visit systolic blood pressure variability and outcomes in hemodialysis. J Hum Hypertens. 2014;28(1):18-24. doi: 10.1038/jhh.2013.49
28. Wang Y, Qin Y, Fan X, et al. Variability in Predialysis Systolic Blood Pressure and Long-Term Outcomes in Hemodialysis Patients. Kidney Blood Press Res. 2018;43(1):115-24. doi: 10.1159/000487111
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1. US Renal Data System. USRDS 2018 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. 2018;2:228.
2. Albeshri MA, Alsallum MS, Sindi S, et al. Hospitalization rate and outcomes in patients with left ventricular dysfunction receiving hemodialysis. Int J Gen Med. 2018;11:463-72. doi: 10.2147/IJGM.S179206
3. Mavrakanas TA, Charytan DM. Cardiovascular complications in chronic dialysis patients. Curr Opin Nephrol Hypertens. 2016;25(6):536-44. doi: 10.1097/MNH.0000000000000280
4. Quarles LD. Reducing cardiovascular mortality in chronic kidney disease: something borrowed, something new. J Clin Invest. 2013;123(2):542-3. doi: 10.1172/JCI67203
5. Gorbunov VM. Modern views on the variability of blood pressure. Rational Pharmacotherapy in Cardiology. 2012;8(6): 810-8 (In Russ.) doi: 10.20996/1819-6446-2012-8-6-810-818
6. Ostroumova OD, Borisova EV, Pavleeva EE. Blood Pressure Variability. Visit-to-Visit Blood Pressure Variability. Kardiologiia. 2017;57(11):68-75 (In Russ.) doi: 10087/cardio.2017.11.10056
7. Troitskaya EA., Kotovskaya YV, Kobalava ZD. Evolution of the views on importance of blood pressure variability. Arterial’naya Gipertenziya. 2013;19(1):6-17
(In Russ.) doi: 10.18705/1607-419X-2013-19-1-6-17
8. Flythe JE, Brunelli SM. Blood pressure variability among chronic dialysis patients: recent advances in knowledge. Curr Opin Nephrol Hypertens. 2015;24(2):163-9. doi: 10.1097/MNH.0000000000000107
9. Rothwell PM. Limitations of the usual blood-pressure hypothesis and importance of variability, instability, and episodic hypertension. Lancet. 2010;375(9718):938-48. doi: 10.1016/S0140-6736(10)60309-1
10. Kramer A, Pippias M, Noordzij M, et al. The European Renal Association – European Dialysis and Transplant Association (ERA-EDTA) Registry Annual Report 2016: a summary. Clin Kidney J. 2019;12(5):702-20. doi: 10.1093/ckj/sfz011
11. Rubinger D, Backenroth R, Sapoznikov D. Sympathetic Nervous System Function and Dysfunction in Chronic Hemodialysis Patients. Semin Dial. 2013;26(3):333-43. doi: 10.1111/sdi.12093
12. Gutiérrez-Adrianzén OA, Moraes ME, Almeida AP, et al. Pathophysiological, cardiovascular and neuroendocrine changes in hypertensive patients during the hemodialysis session. J Hum Hypertens. 2015;29(6):366-72. doi: 10.1038/jhh.2014.93
13. Karpetas A, Loutradis C, Bikos A, et al. Blood pressure variability is increasing from the first to the second day of the interdialytic interval in hemodialysis patients. J Hypertens. 2017;35(12):2517-26. doi: 10.1097/HJH.0000000000001478
14. Wang JG, Yan P, Jeffers BW. Effects of amlodipine and other classes of antihypertensive drugs on long-term blood pressure variability: evidence from randomized controlled trials. J Am Soc Hypertens. 2014;8(5):340-9. doi: 10.1016/j.jash.2014.02.004
15. Rossignol P, Cridlig J, Lehert P, et al. Visit-to-visit blood pressure variability is a strong predictor of cardiovascular events in hemodialysis: insights from FOSIDIAL. Hypertension. 2012;60(2):339-46. doi: 10.1161/HYPERTENSIONAHA.111.190397
16. Juhanoja EP, Niiranen TJ, Johansson JK, et al. Outcome-Driven Thresholds for Increased Home Blood Pressure Variability. Hypertension. 2017;69(4):599-607. doi: 10.1161/HYPERTENSIONAHA.116.08603
17. Stevens SL, Wood S, Koshiaris C, et al. Blood pressure variability and cardiovascular disease: systematic review and meta-analysis. BMJ. 2016;354:i4098. doi: 10.1136/bmj.i4098
18. Feng Y, Li Z, Liu J, et al. Association of short-term blood pressure variability with cardiovascular mortality among incident hemodialysis patients. Ren Fail. 2018;40(1):259-64. doi: 10.1080/0886022X.
2018.1456456
19. Liao R, Li J, Xiong Y, et al. Association of Peridialysis Blood Pressure and Its Variability with Cardiovascular Events in Hemodialysis Patients. Kidney Blood Press Res. 2018;43(4):1352-62. doi: 10.1159/000492595
20. Selvarajah V, Pasea L, Ojha S, et al. Pre-Dialysis Systolic Blood Pressure-Variability Is Independently Associated with All-Cause Mortality in Incident Haemodialysis Patients. PLoS One. 2014;9(1):e86514. doi: 10.1371/journal.pone.0086514
21. Norioka N, Iwata S, Yanagi S, et al. Higher visit-to-visit intra-dialytic blood pressure is associated with the progression of aortic valve stenosis in chronic hemodialysis patients. Heart Vessels. 2016;31(9):1491-6. doi: 10.1007/s00380-015-0756-z
22. Cheng Y, Zhang F, Zhu J, et al. Influence of blood pressure variability on the life of arteriovenous fistulae in maintenance hemodialysis patients. Clin Hemorheol Microcirc. 2016;62(2):129-37. doi: 10.3233/CH-151959
23. Flythe JE, Brunelli SM. Blood pressure variability and dialysis: variability may not always be the spice of life. J Am Soc Nephrol. 2014;25(4):650-3. doi: 10.1681/ASN.2013111237
24. Shafi T, Sozio SM, Bandeen-Roche K, et al. DEcIDE Network Patient Outcomes in End Stage Renal Disease Study Investigators. Predialysis Systolic BP Variability and Outcomes in Hemodialysis Patients. J Am Soc Nephrol. 2014;25(4):799-809. doi: 10.1681/ASN.2013060667
25. Umemoto S, Ogihara T, Matsuzaki M, et al. Effects of calcium channel blocker-based combinations on intra-individual blood pressure variability: post hoc analysis of the COPE trial. Hypertens Res. 2016;39(1):46-53. doi: 10.1038/hr.2015.104
26. Loutradis C, Bikos A, Raptis V, et al. Nebivolol reduces short-term blood pressure variability more potently than irbesartan in patients with intradialytic hypertension. Hypertens Res. 2019;42(7):1001-10. doi: 10.1038/s41440-018-0194-2
27. Chang TI, Flythe JE, Brunelli SM, et al. Visit-to-visit systolic blood pressure variability and outcomes in hemodialysis. J Hum Hypertens. 2014;28(1):18-24. doi: 10.1038/jhh.2013.49
28. Wang Y, Qin Y, Fan X, et al. Variability in Predialysis Systolic Blood Pressure and Long-Term Outcomes in Hemodialysis Patients. Kidney Blood Press Res. 2018;43(1):115-24. doi: 10.1159/000487111
ФГБОУ ВО «Приволжский исследовательский медицинский университет» Минздрава России, Нижний Новгород, Россия
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A.S. Tokareva, N.Yu. Borovkova
Privolzhsky Research Medical University, Nizhny Novgorod, Russia