Blood Pressure Control in Patients with ESKD Treated with Hemodialysis or Peritoneal Dialysis: Results of a Case-Control Study

Background: Hypertension is frequently found in patients with end-stage kidney disease (ESKD) treated with hemodialysis (HD) or peritoneal dialysis (PD). The aim of this study was to compare the blood pressure control in adequately selected patients with ESKD treated with HD or PD. Methods: In this single center, case-control study 60 patients treated with HD and 60 patients treated with PD were enrolled and matched by age and gender (aged 49±16 years, 36M and 24F in each group). In all patients, three office blood pressure measurements in consecutive, separate visits in the outpatient clinic and plasma sodium and potassium concentration measurements were performed. Blood pressure measurements in HD patients were completed before three subsequent dialysis sessions within one week. Results: The prevalence of hypertension was 90% in HD patients and 87% in PD patients. It has been shown that mean systolic blood pressure was higher in patients treated with HD than treated with PD (140.0±17.1 vs. 134.1±11.7 mmHg, respectively, p=0.02). There was no significant difference between studied groups in mean diastolic blood pressure (83.2±11.3 vs. 83.2±8.4 mmHg) and number of using antihypertensive drugs (2.8±1.4 vs. 2.8±1.1), respectively. There was no significant difference between groups in using angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, calcium channel antagonists, beta-adrenergic antagonists, alfa-adrenergic antagonists and clonidine. The use of diuretics in PD patients was more common than in HD patients. There was no difference in the prevalence of diabetes mellitus in studied groups (13.7% vs 20%, respectively), BMI (25.0±4.2 vs. 25.3±3.9) and plasma sodium concentration (139.1±3.7 vs. 139.2±3.3 mmol/L), respectively. Potassium plasma concentration was higher in HD patients than in PD patients (5.04±0.80 vs. 4.52±0.62 mmol/L, p<0.001, respectively). Residual diuresis in PD patients was higher than in HD patients (1298 mL vs. 437 mL, p<0.001). Conclusion: 1. Results of this study may suggest that in ESKD patients treated with hemodialysis blood pressure was less adequately controlled than in patients treated with peritoneal dialysis. 2. Hemodialysis patients need more efforts to control blood pressure than peritoneal dialysis patients. Funding: Government Support – Non-U.S.