Skip to main content

Main menu

  • Home
  • Content
    • Published Ahead of Print
    • Current Issue
    • Archives
    • Saved Searches
    • Topics by Section
  • Authors
    • Submit a Manuscript
    • Author Resources
    • Reprints
  • Editorial Board
  • Subscriptions
  • More
    • About JASN
    • Advertising
    • Feedback
    • JASN Relaunch
    • Editorial Fellowship Program
  • Other
    • CJASN
    • Kidney News Online
    • In the Loop
    • American Society of Nephrology

User menu

  • Register
  • Subscribe
  • My alerts
  • Log in
  • My Cart

Search

  • Advanced search
American Society of Nephrology
  • Other
    • CJASN
    • Kidney News Online
    • In the Loop
    • American Society of Nephrology
  • Register
  • Subscribe
  • My alerts
  • Log in
  • My Cart
American Society of Nephrology

Advanced Search

  • Home
  • Content
    • Published Ahead of Print
    • Current Issue
    • Archives
    • Saved Searches
    • Topics by Section
  • Authors
    • Submit a Manuscript
    • Author Resources
    • Reprints
  • Editorial Board
  • Subscriptions
  • More
    • About JASN
    • Advertising
    • Feedback
    • JASN Relaunch
    • Editorial Fellowship Program
  • Follow JASN on Twitter
  • Visit ASN on Facebook
  • Follow JASN on RSS
  • Community Forum
Clinical Research
You have accessRestricted Access

Association of Ambulatory Blood Pressure with All-Cause and Cardiovascular Mortality in Hemodialysis Patients: Effects of Heart Failure and Atrial Fibrillation

Christopher C. Mayer, Julia Matschkal, Pantelis A. Sarafidis, Stefan Hagmair, Georg Lorenz, Susanne Angermann, Matthias C. Braunisch, Marcus Baumann, Uwe Heemann, Siegfried Wassertheurer and Christoph Schmaderer
JASN September 2018, 29 (9) 2409-2417; DOI: https://doi.org/10.1681/ASN.2018010086
Christopher C. Mayer
Center for Health and Bioresources, Biomedical Systems, AIT Austrian Institute of Technology GmbH, Vienna, Austria;Institute for Analysis and Scientific Computing, Vienna University of Technology, Vienna, Austria;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Christopher C. Mayer
Julia Matschkal
Department of Nephrology, Technical University of Munich, Klinkum rechts der Isar, Munich, Germany;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Pantelis A. Sarafidis
Department of Nephrology, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece; and
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Stefan Hagmair
Center for Health and Bioresources, Biomedical Systems, AIT Austrian Institute of Technology GmbH, Vienna, Austria;Institute for Analysis and Scientific Computing, Vienna University of Technology, Vienna, Austria;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Georg Lorenz
Department of Nephrology, Technical University of Munich, Klinkum rechts der Isar, Munich, Germany;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Susanne Angermann
Department of Nephrology, Technical University of Munich, Klinkum rechts der Isar, Munich, Germany;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Matthias C. Braunisch
Department of Nephrology, Technical University of Munich, Klinkum rechts der Isar, Munich, Germany;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Marcus Baumann
Internistische Fachklinik Dr. Steger, Nuremberg, Germany
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Uwe Heemann
Department of Nephrology, Technical University of Munich, Klinkum rechts der Isar, Munich, Germany;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Siegfried Wassertheurer
Center for Health and Bioresources, Biomedical Systems, AIT Austrian Institute of Technology GmbH, Vienna, Austria;Institute for Analysis and Scientific Computing, Vienna University of Technology, Vienna, Austria;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Christoph Schmaderer
Department of Nephrology, Technical University of Munich, Klinkum rechts der Isar, Munich, Germany;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • PDF
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Visual Overview

Figure1
  • Download figure
  • Open in new tab
  • Download powerpoint

Abstract

Background Evidence on the utility of ambulatory BP monitoring for risk prediction has been scarce and inconclusive in patients on hemodialysis. In addition, in cardiac diseases such as heart failure and atrial fibrillation (common among patients on hemodialysis), studies have found that parameters such as systolic BP (SBP) and pulse pressure (PP) have inverse or nonlinear (U-shaped) associations with mortality.

Methods In total, 344 patients on hemodialysis (105 with atrial fibrillation, heart failure, or both) underwent ambulatory BP monitoring for 24 hours, starting before a dialysis session. The primary end point was all-cause mortality; the prespecified secondary end point was cardiovascular mortality. We performed linear and nonlinear Cox regression analyses for risk prediction to determine the associations between BP and study end points.

Results During the mean 37.6-month follow-up, 115 patients died (47 from a cardiovascular cause). SBP and PP showed a U-shaped association with all-cause and cardiovascular mortality in the cohort. In linear subgroup analysis, SBP and PP were independent risk predictors and showed a significant inverse relationship to all-cause and cardiovascular mortality in patients with atrial fibrillation or heart failure. In patients without these conditions, these associations were in the opposite direction. SBP and PP were significant independent risk predictors for cardiovascular mortality; PP was a significant independent risk predictor for all-cause mortality.

Conclusions This study provides evidence for the U-shaped association between peripheral ambulatory SBP or PP and mortality in patients on hemodialysis. Furthermore, it suggests that underlying cardiac disease can explain the opposite direction of associations.

  • blood pressure
  • pulse pressure
  • ESRD
  • hemodialysis
  • risk prediction
  • heart
  • disease
  • Copyright © 2018 by the American Society of Nephrology
View Full Text

Log in using your username and password

Forgot your user name or password?

Log in through your institution

You may be able to gain access using your login credentials for your institution. Contact your library if you do not have a username and password.

Purchase access

Pay Per Article - You may access this article (from the computer you are currently using) for 1 day for US$27.00

When you create an account, you will be asked for your name, email address and other information.  Just like commercial web sites, we do need details from you in order to complete your purchase of an article.  Select the "Create an Account" link to create your account. 

You will then be asked to register a user name, email address and you will need to create a password that is at least eight characters in length. As you move through the registration page, you will have to verify you are a person by completing a Captcha request.   Lastly, your first and last name will be required. 

Once your information is successfully saved, the system will redisplay the home page of the journal.  From there, navigate back to the article to purchase.  Select the article and at the bottom of the page, use the credentials you just created to login. The article will be added to your shopping cart.  You can continue to navigate across JASN and CJASN adding to your cart from both journals. When you are ready to complete your purchse, select the Shopping Cart from the upper right hand corner of the page and follow the onscreen instructions. 

PreviousNext
Back to top

In this issue

Journal of the American Society of Nephrology: 29 (9)
Journal of the American Society of Nephrology
Vol. 29, Issue 9
September 2018
  • Table of Contents
  • Table of Contents (PDF)
  • About the Cover
  • Index by author
View Selected Citations (0)
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article
Thank you for your help in sharing the high-quality science in JASN.
Enter multiple addresses on separate lines or separate them with commas.
Association of Ambulatory Blood Pressure with All-Cause and Cardiovascular Mortality in Hemodialysis Patients: Effects of Heart Failure and Atrial Fibrillation
(Your Name) has sent you a message from American Society of Nephrology
(Your Name) thought you would like to see the American Society of Nephrology web site.
Citation Tools
Association of Ambulatory Blood Pressure with All-Cause and Cardiovascular Mortality in Hemodialysis Patients: Effects of Heart Failure and Atrial Fibrillation
Christopher C. Mayer, Julia Matschkal, Pantelis A. Sarafidis, Stefan Hagmair, Georg Lorenz, Susanne Angermann, Matthias C. Braunisch, Marcus Baumann, Uwe Heemann, Siegfried Wassertheurer, Christoph Schmaderer
JASN Sep 2018, 29 (9) 2409-2417; DOI: 10.1681/ASN.2018010086

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Request Permissions
Share
Association of Ambulatory Blood Pressure with All-Cause and Cardiovascular Mortality in Hemodialysis Patients: Effects of Heart Failure and Atrial Fibrillation
Christopher C. Mayer, Julia Matschkal, Pantelis A. Sarafidis, Stefan Hagmair, Georg Lorenz, Susanne Angermann, Matthias C. Braunisch, Marcus Baumann, Uwe Heemann, Siegfried Wassertheurer, Christoph Schmaderer
JASN Sep 2018, 29 (9) 2409-2417; DOI: 10.1681/ASN.2018010086
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like

Jump to section

  • Article
    • Visual Overview
    • Abstract
    • Methods
    • Results
    • Discussion
    • Disclosures
    • Acknowledgments
    • Footnotes
    • References
  • Figures & Data
  • Info & Metrics
  • PDF

More in this TOC Section

  • Iron, Hepcidin, and Death in Human AKI
  • A Randomized Trial of Zoledronic Acid to Prevent Bone Loss in the First Year after Kidney Transplantation
  • Simple Postoperative AKI Risk (SPARK) Classification before Noncardiac Surgery: A Prediction Index Development Study with External Validation
Show more Clinical Research

Cited By...

  • No citing articles found.
  • Scopus (1)
  • Google Scholar

Similar Articles

Related Articles

  • No related articles found.
  • Scopus
  • PubMed
  • Google Scholar

Keywords

  • blood pressure
  • pulse pressure
  • ESRD
  • hemodialysis
  • risk prediction
  • heart
  • disease

About

  • JASN
  • ASN Journals
  • ASN Podcasts
  • About ASN
  • JASN Relaunch

Author Information

  • Manuscript Submission
  • Information for Authors
  • Reuse/Reprint Policy

More Information

  • Advertise
  • Subscribe
  • Email Alerts

© 2019 American Society of Nephrology

Print ISSN - 1046-6673 Online ISSN - 1533-3450

Powered by HighWire