Hemodiyalizde Rutinde Ölçülen Kan Basıncı Değerlerinin Standartlara Uygun Ölçülen Kan Basıncı Değerleri ile Karşılaştırılması

Yıl 2020, , 235 - 239, 30.09.2020

Derya Duman Emre Erdem , Tevfik Ecder

https://doi.org/10.47565/ndthdt.2020.20

Öz

Amaç: Çalışmada hemodiyaliz öncesi ve sonrası rutin pratikte ölçülen kan basıncı değerlerinin hemodiyaliz öncesi ve sonrası kılavuzların önerdiği şekilde standartlara uygun ölçülen kan basıncı değerlerinden ne kadar farklı olduğunu araştırdık.
Gereç ve Yöntemler: Çalışma 76 hemodiyaliz hastası ile gerçekleştirildi. Hastalar hemodiyaliz merkezine geldikten sonra kılavuzların önerdiği şekilde standartlara uygun kan basıncı ölçümü yapıldı. Hastaların standart kan basıncı ölçüldükten sonra diyaliz öncesi rutin kan basınçları ölçüldü. Diyaliz tamamlandıktan sonra hastaların diyaliz sonrası rutin ve standartlara uygun kan basıncı ölçümleri yapıldı.
Bulgular: Hastaların hemodiyaliz öncesi standartlara uygun ölçülen sistolik kan basıncı (SKB) ortalaması, rutin ölçülen SKB ortalamasından daha düşüktü (129 ± 25 vs.134 ± 25 mm Hg; p< 0.0001). Hemodiyaliz öncesi standart diyastolik kan basıncı (DKB) ortalaması da, rutin DKB ortalamasından daha düşüktü (74 ± 12 vs. 77 ± 14 mm Hg; p<0.0001). Hemodiyaliz sonrası ölçümlerde ise standart SKB ortalaması ile rutin SKB ortalaması arasında anlamlı fark yoktu (115 ± 24 vs 113 ± 26; p>0.05). Hemodiyaliz sonrası standart DKB ortalaması, rutin DKB ortalamasından daha yüksek idi (71 ± 12 vs. 68 ± 14 mm Hg; p=0.043).
Sonuç: Hemodiyaliz öncesi standartlara uygun ölçülen SKB ve DKB, rutin ölçümlere göre sıklıkla daha düşüktür.

Anahtar Kelimeler

Kan basıncı, kan basıncı ölçümü, Hemodiyaliz

Destekleyen Kurum

yok

Proje Numarası

yok

Teşekkür

yok

Comparison of Blood Pressure Values Measured Routinely with the Values Measured Accordingly to the Standards in Hemodialysis

Öz

Objective: In this study, we investigated how predialysis and post-dialysis blood pressure values measured in routine practice differ from the blood pressure values measured accordingly to the standards, as suggested by the guidelines.
Material and Methods: This study was performed with 76 hemodialysis patients. After the patients came to the hemodialysis center, blood pressure measurement was performed accordingly to the standards as recommended by the guidelines. After the standard blood pressure of the patients were measured, routine predialysis blood pressures were measured. After dialysis was completed, post-dialysis blood pressure measurements of patients accordingly to routine and standards were performed.
Results: The mean predialysis standard systolic blood pressure (SBP) value was lower than the mean routine SBP value (129 ± 25 vs.134 ± 25 mmHg; p< 0.0001). The mean predialysis standard diastolic blood pressure (DBP) value as well as lower than the mean routine DBP value (74 ± 12 vs. 77 ± 14 mmHg; p<0.0001). The mean post-dialysis SBP values were not significantly different between the standard and routine measurements (115 ± 24 vs 113 ± 26; p>0.05). The mean post-dialysis standard DBP measurement was higher than the routine DBP (71±12 vs. 68±14 mmHg; p=0.043).
Conclusion: Predialysis standard SBP and DBP measurements are usually lower than the routine measurements.

Anahtar Kelimeler

Blood pressure, Blood pressure measurement, Hemodialysis

Proje Numarası

yok

Kaynakça

• 1.Khan YH, Sarriff A, Adnan AS, Khan AH, Mallhi TH. Blood Pressure and Mortality in Hemodialysis Patients: A Systematic Review of an Ongoing Debate. Ther Apher Dial 2016; 20(5): 453-461.
• 2. Agarwal R. Blood pressure and mortality among hemodialysis patients. Hypertension 2010; 55(3): 762-768.
• 3. Hörl MP, Hörl WH. Hemodialysis-associated hypertension: pathophysiology and therapy. Am J Kidney Dis 2002; 39(2): 227-244.
• 4. K/DOQI Workgroup. K/DOQI clinical practice guidelines for cardiovascular disease in dialysis patients. Am J Kidney Dis 2005; 45(4 Suppl 3): S1-153.
• 5. Sarafidis PA, Persu A, Agarwal R, Burnier M, de Leeuw P, et al. Hypertension in dialysis patients: a consensus document by the European Renal and Cardiovascular Medicine (EURECA-m) working group of the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) and the Hypertension and the Kidney working group of the European Society of Hypertension (ESH). Nephrol Dial Transplant 2017; 32(4): 620-640.
• 6. Akpolat T, Kaya C, Utaş C, Arinsoy T, Taşkapan H, et al. Arm circumference: its importance for dialysis patients in the obesity era. Int Urol Nephrol 2013; 45(4): 1103-1110.
• 7. Sankaranarayanan N, Santos SF, Peixoto AJ. Blood pressure measurement in dialysis patients. Adv Chronic Kidney Dis 2004; 11(2): 134-142.
• 8. Lazar AE, Smith MC, Rahman M. Blood Pressure Measurement in Hemodialysis Patients. Semin Dial 2004; 17(4): 250-254.
• 9. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, et al. National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; National High Blood Pressure Education Program Coordinating Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003; 289(19): 2560-2572.
• 10. Rahman M, Griffin V, Kumar A, Manzoor F, Wright JT Jr, et al. A comparison of standardized versus "usual" blood pressure measurements in hemodialysis patients. Am J Kidney Dis 2002; 39(6): 1226-1230.
• 11. Agarwal R, Brim NJ, Mahenthiran J, Andersen MJ, Saha C. Out-of-hemodialysis-unit blood pressure is a superior determinant of left ventricular hypertrophy. Hypertension 2006; 47(1): 62-68.
• 12. Kubrusly M, de Oliveira CM, Silva RP, Pinheiro MA, Rocha MB, et al. Blood pressure measurement in hemodialysis: The importance of the measurement technique. Saudi J Kidney Dis Transpl 2006; 27(2): 241-249.
• 13. Erdem E. The effects of passive leg raising and ultrafiltration stopping on blood pressure in hemodialysis patients. Int Urol Nephrol 2016; 48(6): 877-882.
• 14. Kooman J, Basci A, Pizzarelli F, Canaud B, Haage P, et al. EBPG guideline on haemodynamic instability. Nephrol Dial Transplant 2007; 22 (Suppl 2): ii22-44.