Blood pressure and target-organ damage in hemodialysis: but which blood pressure?

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We have read with interest the study of Sarak et al.[1], which aimed to explore the association of blood pressure (BP) with the 12-month-long change in left ventricular (LV) mass index (LVMI) in a small cohort of 57 hemodialysis patients. The predictors of this longitudinal analysis were the BP recordings obtained prediadialysis and postdiadialysis (e.g. peridialytic BP) as well as BP measurements routinely taken immediately after dialysis initiation and nadir BPs recorded whenever during dialysis (e.g. intradialytic BP). The outcome of interest was the change in LVMI that was recorded via magnetic resonance imaging as an approach to obtain a volume-independent determination of LV hypertrophy [1]. This analysis showed that mean arterial pressure recorded after dialysis initiation was stronger predictor of the change in LVMI than was predialysis and postdialysis BP [1].

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