Volume 76, Issue 10, Pages (November 2009)

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Volume 76, Issue 10, Pages 1098-1107 (November 2009) Decreased pulse pressure during hemodialysis is associated with improved 6-month outcomes Jula K. Inrig, Uptal D. Patel, Robert D. Toto, Donal N. Reddan, Jonathan Himmelfarb, Robert M. Lindsay, John Stivelman, James F. Winchester, Lynda A. Szczech Kidney International Volume 76, Issue 10, Pages 1098-1107 (November 2009) DOI: 10.1038/ki.2009.340 Copyright © 2009 International Society of Nephrology Terms and Conditions

Figure 1 Average pre- and post-dialysis systolic blood pressure (SBP) and diastolic blood pressure (DBP) among subjects grouped by quartiles of pulse pressure (PP) change during dialysis. HD, hemodialysis. Kidney International 2009 76, 1098-1107DOI: (10.1038/ki.2009.340) Copyright © 2009 International Society of Nephrology Terms and Conditions

Figure 2 Adjusted* hazard ratio for hospitalization or death associated with the following blood pressure parameters analyzed in six separate models. (1) Pre-dialysis pulse pressure modeled individually. (2) Post-dialysis pulse pressure modeled individually. (3) Change in pulse pressure during hemodialysis modeled individually. (4) Pre-dialysis pulse pressure and post-dialysis pulse pressure modeled together. (5) Pre-dialysis pulse pressure and change in pulse pressure during hemodialysis modeled together. (6) Post-dialysis pulse pressure and change in pulse pressure during hemodialysis modeled together. *In addition to the listed blood pressure parameter(s), each model is adjusted for age, race, gender, dry weight, intradialytic weight loss, tobacco use, diabetes, cerebrovascular disease, coronary artery disease, congestive heart failure, presence of left ventricular hypertrophy, hypoalbuminemia, serum calcium, phosphorus, hemoglobin, nitrate, and treatment arm. CI, confidence interval; HD, hemodialysis; HR, hazard ratio; PP, pulse pressure. Kidney International 2009 76, 1098-1107DOI: (10.1038/ki.2009.340) Copyright © 2009 International Society of Nephrology Terms and Conditions

Figure 3 Monthly average change in pulse pressure during dialysis across quartiles of subjects categorized by baseline pulse pressure change during hemodialysis. Kidney International 2009 76, 1098-1107DOI: (10.1038/ki.2009.340) Copyright © 2009 International Society of Nephrology Terms and Conditions

Figure 4 Adjusted* hazard ratio for hospitalization or death associated with decrease in pulse pressure during hemodialysis (per 10mmHg) among the following four strata of pre-dialysis systolic blood pressure: (1) Pre-dialysis systolic blood pressure <120mmHg (HR 1.39, CI 0.72–2.76, per 10-mmHg decrease in pulse pressure with hemodialysis). (2) Pre-dialysis systolic blood pressure 120–139mmHg (HR 0.78, CI 0.54–1.13, per 10-mmHg decrease in pulse pressure with hemodialysis). (3) Pre-dialysis systolic blood pressure 140–159mmHg (HR 0.76, CI 0.60–0.97, per 10-mmHg decrease in pulse pressure with hemodialysis). (4) Pre-dialysis systolic blood pressure ≥160mmHg (HR 0.79, CI 0.59–1.06, per 10-mmHg decrease in pulse pressure with hemodialysis). *Each model is adjusted for age, race, gender, dry weight, intradialytic weight loss, tobacco use, pre-dialysis systolic blood pressure, diabetes, cerebrovascular disease, coronary artery disease, congestive heart failure, presence of left ventricular hypertrophy, hypoalbuminemia, serum calcium, phosphorus, hemoglobin, nitrate, and treatment arm. CI, confidence interval; HD, hemodialysis; HR, hazard ratio; PP, pulse pressure; SBP, systolic blood pressure. Kidney International 2009 76, 1098-1107DOI: (10.1038/ki.2009.340) Copyright © 2009 International Society of Nephrology Terms and Conditions