Table 1.

Deographic and clinical characteristics of studies included in meta-analysisa

StudyYearnPopulationAge(yr)% DiabetesIDWG (kg)% on BP MedicationsNo. of BP Medications in UsersSystolicDiastolicAmbulatory BP MeasurementBP MeasurementReference
ABPMPre-HDPost-HDABPMPre-HDPost-HD
Kooman (35)199222Four hypotensive, six normotensives, 12 hypertensive patients studied540%2.8 ± 1.454.5%Median of two drugs in hypertensives129 ± 36142 ± 42124 ± 2472 ± 1879 ± 1674 ± 22SpaceLabs 90207, 48 h, including the dialysis sessionDialysis BP was measured after 15 min of rest before and after dialysis(31)
Cheigh (21)199253Treated hypertensive hemodialysis patients, 58% men, 47% black53 ± 1330%2.9 ± 0.9100.0%NA158.6 ± 22.7163.9 ± 27.7154.0 ± 29.688.7 ± 16.687.9 ± 18.088.9 ± 20.1SpaceLab 90207 monitor placed 1 h before dialysis for 48 hNA(17)
van de Borne (36)199213Hemodialysis patients without uncontrolled hypertensionNA0%1.8 ± 0.715.4%NA127 ± 28.8144 ± 18.0135 ± 1873 ± 14.281 ± 10.877 ± 10.8TM2421 (A&D Engineering); 25-h recording after the dialysis session; first hour excludedSupine BP after 10 min rest preHD and 20 min rest postdialysis(32)
Huisman (31)199512Normotensive hemodialysis patients, all white, eight men56 ± 148%2.3 ± 1.20.0%None126.5 ± 17140.8 ± 20.3121.2 ± 18.176.1 ± 8.986.6 ± 12.576.2 ± 11.1SpaceLabs 90207, 48 h, including the first and second dialysis sessionsNot stated(27)
Erturk (37)199640No exclusion criteria specified, 73% male31.6 ± 8.90%2.6 ± 1.177.5%1.6138.4 ± 24.6134.5 ± 25.5130.3 ± 22.793.7 ± 15.185.3 ± 13.879.1 ± 15.6Pressurescan, ERKA, excluded bracketing dialysis sessionsSingle measurements bracketing the ABPM recorded in the dialysis unit by one physician in duplicate using a mercury sphygmomanometer(33)
Conlon (33)199635Stable Hct between 27 and 33% for previous 3 mo and no change in BP medications during the same period; 66% men, 86% black43 ± 1043%3.3 ± 1.574.3%1.5150 ± 18160.5 ± 19.7133 ± 19.774.2 ± 1082.1 ± 9.375.9 ± 11.2Stuart Medical ABP monitor, 24-h recording that included the first dialysis sessionAverage of 12 predialysis readings recorded after quiet rest for 10 min in seated position by nonphysicians using a calibrated aneroid sphygmomanometer(29)
Elisaf (40)199612Hypertensive hemodialysis patients included in this meta-analysis54NANA100.0%NA156 ± 19157 ± 11146 ± 1993 ± 1189 ± 1082 ± 10SpaceLabs 90207, included the dialysis sessionAverage of three recordings in seated position, 15 min before or after dialysis(35)
Savage (22)199727Hemodialysis patients on dialysis >6 mo, 67% men43.8 ± 13.30%1.6 ± 0.855.6%1.7132 ± 19.2138.7 ± 17.5129.7 ± 18.880.8 ± 15.085.5 ± 14.981.5 ± 12.2SpaceLabs 90207, 48 h, started postdialysisNot stated(18)
Mitra (28)199940Randomly selected61.5 ± 14.825%1.34 ± 0.7278.0%1.5 ± 1140 ± 21157 ± 22124 ± 3171.7 ± 1178 ± 1070 ± 13TM2421 (A&D Engineering); recording included the dialysis sessionPreHD measurement over 10 dialysis sessions averaged; BP also was measured over various time points(24)
Zoccalli (38)199964Patients on hemodialysis for at least 3 mo, without heart failure; excluded patients acutely ill49.3 ± 15.90%4.5 ± 139.1%NA135.3 ± 24.2140.7 ± 18.2NA78.8 ± 14.180.2 ± 11.8NATakeda 2420 model 7 or SpaceLabs 90207 on a nondialysis day over 24 hPredialysis BP were averaged over 1 mo (12 readings)(34)
Berns (23)199928Chronic dialysis patients participating in an anemia correction trial; only baseline data used for this meta-analysis; 86% black61.2 ± 1154%NANANA153.7 ± 25154.8 ± 22.3144.3 ± 24.280.2 ± 12.381.3 ± 12.273.9 ± 10.5SpaceLabs 90207, 44 h, excluded bracketing dialysis sessionsAfter 5 min of quiet rest(19)
Conlon (34)200031Chronic dialysis patients participating in an anemia correction trial; only baseline data used for this meta-analysis; 74% black54.7 ± 12.5NANA83.9%1.5148.3 ± 26.5152.1 ± 25.2NA75.0 ± 12.582.6 ± 14.7NAStuart Medical ABP monitor, 24-h recording that included the first dialysis sessionPredialysis BP after 10 min of quiet rest while seated; BP obtained every 4 wk for 28 wk(30)
Canella (32)200055Availability of optimal chest acoustic window, dialysis age of at least 6 mo; patients with diabetes, coronary artery disease, significant valvular regurgitation, CHF, frequent intradialysis hypotension and severe anemia were excludedrange 24–74 yr0%2.51.2126 ± 19142 ± 15135 ± 1676 ± 1280 ± 977 ± 9SpaceLab 90207 monitor placed before dialysis for 24 h and then 15 min before the next dialysisAverage of 12 predialysis and postdialysis reading obtained by the nurses in the month preceding the study(28)
Peixoto (44)200021Repeated ambulatory monitoring to assess reproducibility of ABPM; 67% men; only study 1 included in this meta-analysis53 ± 16NA2.3 ± 1.5NA140 ± 21142 ± 16136 ± 1781 ± 1679 ± 1077 ± 9SpaceLab 90207 monitor and QuietTrak monitors used; interdialytic monitoringFive hemodialysis surrounding ABPM averaged(39)
Agarwal (29)200170Patients needing ABPM for evaluation of hypertension or its treatment; 77% blacks, 54% male59 ± 1734%2.957.1%1.98 ± 0.89144 ± 22158 ± 21.8144.6 ± 22.481 ± 1185.2 ± 9.978.7 ± 9.8SpaceLabs 90207, 44 h, excluded bracketing dialysis sessionsTwo-week dialysis unit BP were averaged(25)
Nishikimi (24)200135Consecutive dialysis patients on dialysis for >6 mo59.5 ± 14.737%2.1 ± 1.268.6%NA134.2 ± 16.5156.0 ± 24136.0 ± 23.179.4 ± 12.278.6 ± 13.075.0 ± 12.9TM2421 (A&D Engineering); 48-h recording that included one dialysis sessionNA(20)
Fagugli (25)200266Hypertensive hemodialysis patients; excluded those on dialysis <6 mo, Kt/V <1.2, and presence of CHF or reduced LV systolic function56.2 ± 17.615%4.2 ± 1.6%NA1.9 ± 1.2147.6 ± 16.5146.7 ± 16.2NA80.7 ± 10.481.6 ± 7.8NATM2421 (A&D Engineering); interdialytic 48 hAverage of 1 mo predialysis BP measurements(21)
Santos (30)200371Patients without unstable CHF, coronary heart disease, or atrial fibrillation who successfully completed ABPM; 50% men45 ± 1414%2.3 ± 1.0262.0%1.7 ± 1.0136 ± 22151 ± 28143 ± 2683 ± 1483 ± 1581 ± 14SpaceLabs 90207, 44 h, excluded bracketing dialysis sessionsAuscultatory measurements using standard guidelines and mercury sphygmomanometers(26)
  • a ABPM, ambulatory BP monitoring; CHF, congestive heart failure; Hct, hematocrit; HD, hemodialysis; IDWG denotes interdialytic weight gain; LV, left ventricular.