The DOI matches its Crossref record; 24 of the 24 references it cites were found in a registry or an index.
Home blood pressure monitoring improves the diagnosis of hypertension in hemodialysis patients
Open accessAbstract
Using interdialytic ambulatory blood pressure (BP) recordings as the reference standard, we compared the performance of routine, standardized and home BP monitoring in 104 predominantly black patients on chronic hemodialysis for at least 3 months. Dialysis unit BP recordings were averaged over 2 weeks and home BP over 1 week. Awake ambulatory BP of > or =135 mmHg systolic or > or =85 mmHg diastolic was taken as evidence of hypertension. Average awake ambulatory BP was 128.1+/-21.6/73.5+/-13.5 mmHg, home BP 141.3+/-21.9/78.7+/-11.9 mmHg, standardized pre-dialysis BP 141.7+/-22.6/74.2+/-13.5 mmHg and post-dialysis 119.9+/-20.5/69.1+/-13.1 mmHg, routine pre-dialysis 145.4+/-21.8/79.0+/-13.1 mmHg and post-dialysis 131.5+/-19.2/72.5+/-11.4 mmHg. Sixty-three percent of the patients had well-controlled BP by ambulatory BP monitoring and isolated diastolic hypertension was rare (3%). The standard deviation of the differences between ambulatory and routine pre-dialysis BP was 17.6 mmHg, routine post-dialysis was 16.1 mmHg, standardized pre-dialysis was 16.4 mmHg, standardized post-dialysis was 14.1 mmHg, and home BP was 14.2 mmHg. The area under receiver operating characteristic curves was similar for home and standardized BP but lower for routine BP. Home systolic BP of > or =150 mmHg averaged over 1 week had the best combination of sensitivity (80%) and specificity (84.1%) in diagnosing systolic hypertension--present in 94% of the hypertensive dialysis patients. Home BP monitoring is similar to standardized recording of BP in hemodialysis patients. A systolic BP threshold of 150 mmHg at home averaged over 1 week serves as a useful predictor of hypertension diagnosed by ambulatory BP monitoring.
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“Patients with CKD on haemodialysis are profoundly different from patients with CKD who are not on dialysis; this is so because of varying states of volume excess among patients and volume accumulation in the interdialytic period [204–206].”
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Cites
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Cardiac Disease Evaluation and Management Among Kidney and Liver Transplantation Candidates
Lentine, K. L., Costa, S. P., Weir, M. R., Robb, J. F., Fleisher, L. A., Kasiske, B. L., Carithers, R. L., Ragosta, M., Bolton, K., Auerbach, A. D., et al. (2012) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2012.05.008 · Cited by 398
Cardiac Disease Evaluation and Management Among Kidney and Liver Transplantation Candidates
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Blood Pressure and Mortality Among Hemodialysis Patients
Agarwal, R. (2010) · Hypertension · doi:10.1161/hypertensionaha.109.144899 · Cited by 274
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Metadata
- Authors
- Agarwal, R., Andersen, M. J., Bishu, K., & Saha, C.
- Affiliations
- Richard L. Roudebush VA Medical Center (US)
- Indiana University Indianapolis (US)
- Corresponding author
- Agarwal, R.
- ORCID
- Venue
- Kidney International
- Publisher
- Elsevier BV
- Published
- 2006-03
- Volume
- 69
- Issue
- 5
- Pages
- 900-906
- ISSN
- 0085-2538 (ISSN-L)
- OpenAlex
- W1963876316
- Cited by
- 175
- References
- 24
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 5 · 2023: 10 · 2022: 8 · 2021: 7 · 2020: 8 · 2019: 9 · 2018: 5 · 2017: 7 · 2016: 12 · 2015: 7 · 2014: 7 · 2013: 7 · 2012: 14
- FWCI
- 8.33
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Kidney International (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Dialysis Clinics
- National Institutes of Health (5t32dk062711-05)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK062030, 5T32DK062711-02)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- home blood pressure monitoring, hypertension diagnosis, hemodialysis patients, ambulatory blood pressure monitoring, systolic hypertension, isolated diastolic hypertension, blood pressure thresholds, Black patients
- MeSH terms
- Adult, Aged, Blood Pressure Determination, Female, Renal Dialysis, Humans, Hypertension, Male, Middle Aged, Sensitivity and Specificity, Blood Pressure Monitoring, Ambulatory
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