| 1st author Year of publication Reference | Aim of the study | Study design Method of BP measurement Follow-up period | Number Population (Country, KRT modality) | Primary Analysis | Results/Conclusion |
|---|---|---|---|---|---|
| Ateya, 2022 (171) | To assess the effect of ramipril vs. placebo on markers of endothelial dysfunction in hypertensive CYP on HD | Double-blind randomised controlled trial Method not specified 16 weeks | 135 Egypt HD | Assessment of markers of endothelial dysfunction (ADMA; hs-CRP, IL-6 and TNF-a) | In the ramipril group, there was an observed reduction in markers of endothelial dysfunction and safe and effective lowering of BP occurred (secondary analysis). Median between group differences for SBP and DBP were −12.0 mmHg (95% CI −18.0 to −9.5) and −9.0 mmHg (95% CI −12.0 to −4.5) respectively (p=<0.001) |
| De Zan, 2021 (179) | To assess BP trends and changes in BP over 1 year in children on conventional HD vs. HDF | Parallel-arm retrospective observational 24-h ABPM in midweek interdialytic interval and manual pre-dialysis BP 1 year | 133 (78 on HD and 55 on HDF) Europe and Canada (multicentre) HD | Assessment of 24-h MAP-SDS, pre-dialysis manual BP, prevalence of hypertension, and change in BP status at baseline and 1 year. Agreement between 24-h MAP-SDS and pre-dialysis manual BP was also analysed. | Despite equivalent dialysis dose, those on HD experienced a significantly sustained increase in BP over 1 year compared to stable BP seen in those on HDF (MAP-SDS increase of +0.98 [p < 0.0001] in the HD group vs. +0.15 [p = 0.23] in the HDF group. Poor agreement was found between manual and 24-h values. |
| Fadel, 2014 (173) | To assess the benefit of non-invasive monitoring of haematocrit (NIVH) in determining dry weight and determining the effect on intra-dialytic morbid events (IME) which included hypotension, light headedness, nausea, vomiting and/or cramps) requiring intervention | Prospective observational Pre- and post-dialysis BP; method not specified 3 months | 15 Egypt HD | Assessment of IME with and without a NIVM-guided UF protocol | There was no significant difference in pre-HD systolic, post-HD systolic, or mean BP (p >0.1 for all) before and after the implementation of the NIVM-guided UF protocol |
| Karava, 2018 (177) | To assess markers of cardiovascular morbidity in CYP on HD with normal BP | Retrospective observational 24-h ABPM Median duration 10.4 months | 19 France HD | Assessment of IDWG and its effect on cIMT, LVMI, and PWV | High IDWG was associated with increased cIMT. Median SBP and DBP values were not significantly different between groups (i.e. IDWG <4% vs. ≥4%) |
| Mitsnefes, 2005 (3) | To determine the prevalence of hypertension and assess risk factors for elevated BP for CYP on dialysis | Retrospective cohort Method not specified Median duration 1 year (up to 5 years) | 3,743 North and Central America (multicentre) HD and PD | Assessment of BP over a 5-year period of HD using data from the NAPRTCS database | Normotensive CYP at baseline experienced a significant increase in BP over the first year of HD, whereas hypertensive CYP experienced a significant decrease in BP (D indexed SBP, -0.081 ± 0.005; p ≤0.001; D indexed DBP, -0.116 ± 0.007; p ≤0.001). BP did not change significantly after the first year of dialysis (51% had uncontrolled hypertension after the first year). Baseline hypertensive status and use of antihypertensive agents were risk factors for subsequent hypertension in logistic regression analysis |
| Özçakar, 2006 (168) | To compare office vs 24-h ABPM values in patients receiving PD (for >2 months) and to assess correlation between BP values and LVH | Prospective observational Office BP taken manually off dialysis 5 months | 25 (9 on ≥1 antihypertensive agent) Turkey PD | Assessment of office BP and 24-h ABPM and correlation with echocardiographic findings associated with LVH | Mean 24-h SBP was higher than office SBP. Systolic hypertension was diagnosed in 32% using office SBP values vs. 56% for mean daytime SBP. There was a significant correlation between LVMI and office BP measurements and all ABPM parameters (excluding SBP and DBP dipping) |
| Paglialonga, 2012 (175) | To assess the usefulness of bioimpedance analysis (BIA) in estimating dry weight in CYP on HD | Retrospective cohort Pre- and post-dialysis BP; method not specified Median duration 5.5 years (non-BIA group) and 4.4 years (BIA group) | 31 Italy HD | Assessment of LVMI and incidence of pulmonary oedema | LVMI was reduced in the BIA group. There was no difference in BP, or number of antihypertensive agents used, per patient with or without use of BIA (secondary analysis) |
| Paglialonga, 2015 (176) | To assess median IDWG in CYP on HD, and explore correlation with various markers, including morphological LV changes | Retrospective observational Pre-dialysis automated Median duration 1.7 years | 16 Italy HD | Assessment of various factors including LVMI, % change in LVMI, % of symptomatic dialysis sessions, and median pre-dialysis SBP and DBP | Significant correlation was found between IDWG and LVMI. Those with IDWG <4% were at lower risk of LVH and had lower median DBP (vs. those in the IDWG >4% group (0.24 vs 1.72, p=0.04) |
| Paglialonga at al, 2023 Pediatr Nephrol DOI: 10.1007/s00467-023-05932-y | To assess an interdialytic simplified sodium balance (sNaB) model in CYP on maintenance dialysis, and explore correlation with BP and IDWG | Prospective observational 24-h ABPM or office BP Median duration 1 year | 41 European (multicentre) HD and PD | Assessment of SBP and DBP standard deviation scores (SDS) according to age, and interdialytic weight gain (IDWG). | sNaB was the strongest predictor of IDWG in multivariate analysis (β=0.63; p=0.005). Neither SBP SDS nor DBP SDS correlated with sNaB. |
| Patel et al, 2007 (174) | To evaluate the effects of introducing an algorithm for non-invasive monitoring of haematocrit on BP control and LVM on CYP on HD | Prospective observational 24-h ABPM 6 months | 16 USA HD | Assessment of the difference in weight, BP, number of antihypertensive medications, 24-h ABPM findings, echocardiographic findings, and UF-associated symptoms between baseline and 6 months | An improvement in ABPM index for both daytime SBP and DBP was observed (p=0.05 for both) despite no significant change in achieved post-HD weight or estimated dry weight |
| Roszkowska-Blaim, 2015 (169) | To evaluate the effect of hypertension and antihypertensive therapies on residual renal function (RRF) in those on PD, and to determine the optimum target BP centile to maintain RRF | Retrospective observational Manual BP 12 months | 87 Poland PD | Analysis of BP, presence and control of HTN, use of antihypertensive medications, and RRF (expressed as daily diuresis) and residual GFR (rGFR) at baseline and 12 months. | In children with uncontrolled HTN, relative daily diuresis loss was higher compared to those with SBP/DBP <95th percentile. In multivariate analysis, relative rGFR decline showed an inversely relationship with SBP percentile (β=0.21, p=0.045) |
| Shroff, 2019 (178) | To compare the effect of HDF vs. HD on various factors including BP control | Prospective cohort 24-h ABPM in midweek interdialytic interval 12 months | 177 Europe and Canada (multicentre) HD | Assessment of BP control, cIMT, height SD score, b2-microglobulin, PTH, patient-reported symptoms, and post-dialysis recovery time | HDF was associated with better MAP SD score compared with HD (at both baseline and 12 months; p <0.001 for both), but there was no significant change in MAP SD score between baseline and 12 months for those on HDF |
| Srisuwan, 2015 (172) | Comparison of blood volume monitoring vs. clinical assessment to guide ultrafiltration to adjust dry weight in CYP on HD | Prospective cohort Pre-, intra- and post-dialysis; automated 8 weeks | 10 Thailand HD | Assessment of the difference between dry weight and post dialysis body weight between use of blood volume monitoring (BVM) and clinical assessment | BVM led to lower dry weight estimation than clinical assessment. There was no difference in pre-dialysis BP and/or intradialytic hypotension episodes between groups (secondary analysis) |
| Ulinski, 2006 (160) | To assess LV mass LVM during an observational period whilst receiving regular HD | Retrospective observational Pre-dialysis BP; method not specified Median duration 16.3 months | 17 France / HD | LVM measurement 3-6 monthly with BP measurement 1 week before and 1 week after each echocardiographic assessment | SBP and DBP decreased over the observational period (p <0.001 for both) and correlated with a reduction in LVM in multivariate analysis |
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