AGE AND ARTERIAL PRESSURE IN HEMODIALYSIS PATIENTS

THE AIM of the investigation was to assess the effects of age on the parameters of systemic arterial pressure (AP) in a group of patients treated by hemodialysis (HD). PATIENTS AND METHODS. Under examination there were 252 patients on chronic HD. The average duration of HD was 62±53 months. Primary renal pathology was presented by chronic glomerulonephritis (68%), polycystosis of the kidneys (9%), malformations of the urinary tracts (7%), interstitial diseases (16%). Mean values of the age in the group under examination were 42.9±12.7 years (1974 years, 95% confidence interval 41.444.5 years). RESULTS. A comparative analysis of mean values of systolic (SAP), diastolic (DAP), average (APaver) and pulse AP (PAP) has revealed that AD (PAP excluded) has lower values in the group of elderly patients of 6074 years of age, and the highest values  among the patients of 1944 years of age. The AP values in 4559 year old patients were intermediate (all Panova <0.005). A clear negative dependence was found between the current age of the HD patients and the values of SAP, DAP and APaver(all p<0.001). PAP did not depend on the age (r=0.107, p=0.09). By the data of multiple regressive analysis the age was included in the group of independent and reliable predictors of the APaver level (β=0.269, p=0.0003) along with the duration of the dialysis therapy (β=0.311, p=0.000021), duration of the HD procedure (β=0.241, p=0.0007), the aorta diameter (β=0.176, p=0.0189) and the calciumphosphate product (Ca* P) (β=0.154, p=0.0274). The same analysis used for SAP and DAP gave similar results with the retained high reliability of the final regression model (R2 =0.324, p=0.0001 and R2 =0.313, p=0.0001, respectively). PAP was determined by the duration of HD treatment (β=0.3, p=0.00002), average duration of the HD procedure (β=0.19, p=0.008) and Ca* P (β=0.2, p=0.005). CONCLUSION. The data obtained need additional investigations in order to specify the mechanisms of agedependent change of AP and show a more careful approach to be necessary to its control in patients of the middle and elderly age including pharmacotherapy and choice of the HD regimen.

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