Blood pressure variability is associated with major adverse cardiovascular events in patients on maintenance peritoneal dialysis

Objective To investigate the association between one-week blood pressure variability (BPV) and major adverse cardiovascular events (MACEs) in patients on maintenance peritoneal dialysis. Methods A total of 85 patients undergoing maintenance peritoneal dialysis for at least 3 months in Nanyang Central Hospital from January 2014 to January 2016 were enrolled into our study. One-week morning blood pressures upon waking up and other clinical data obtained from peritoneal dialysis assessment upon admission were collected, and the patients were divided into the high BPV group (CV >11.0%) and low BPV group (CV ≤ 11.0%) based on the median coefficient of variation (CV) of the blood pressure data. All the patients were followed up until May 2017, so as to monitor incidences of MACEs (cardiovascular death, cardiovascular infarction required for hospitalization, angina pectoris, heart failure, stroke). Results In both of the high BPV group and low BPV group, dialysis related indices (dialysis age, Kt/V, daily dialysis effluent), proportion of primary cases, calcium and phosphorus metabolism, blood lipid, hemoglobin and blood albumin showed no statistically significant difference. Through median 15-month follow-up, it was found that the total incidence of MACEs was 24.7% in the patients on maintenance peritoneal dialysis, with the highest incidence of heart failure (15.3%). The total incidence of the high BPV group (30.4%) was higher than the low BPV group (17.9%), but with no statistical significance (P=0.181). The median survival time without adverse cardiovascular events for the peritoneal dialysis patients was 30.5 months (27.2, 33.8), and the survival time of 33.9 (30.1, 37.8) months for the low BPV group was higher than the time of 27.1 (22.1, 32.1) months for the high BPV group (Log rank test, χ²=4.649,P<0.05). Conclusions The blood pressure variability has close association with the survival time without adverse cardiovascular events in patients on maintenance peritoneal dialysis. The higher of the blood pressure variability, the shorter the survival time without adverse cardiovascular events.