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        "resumen" => "Objetivo: Evaluar la prevalencia de hipertensión arterial (HTA) en pacientes en programa de hemodiálisis en Cataluña y analizar los factores clínicos y bioquímicos asociados. Método: Estudio multicéntrico, transversal y observacional que incluyó una muestra representativa de pacientes hemodializados en situación estable (más de 6 meses) de todos los centros de hemodiálisis de Cataluña, tanto hospitalarios como ambulatorios. Se recogieron variables clínicas y bioquímicas basales y se determinó la presión arterial prediálisis (3 determinaciones) en cada sesión durante 1 mes, además de registrarse el peso pre y post-diálisis semanalmente. Se definió HTA como la presencia de uno o más de los siguientes criterios: media (12 determinaciones) de presión arterial sistólica ≥140 mmHg, de presión diastólica ≥90 mmHg o tratamiento antihipertensivo durante al menos 3 meses. Resultados: Se estudiaron 387 pacientes de 32 de los 40 centros, 231 de los cuáles eran varones, con medias de edad de 63 ± 14 años. La prevalencia de HTA en esta muestra fue de 67,4%, que varió de acuerdo con la etiología de la insuficiencia renal crónica terminal: diabética 81%, vascular 81%, glomerulonefritis 61%, poliquistosis 52%, desconocida y otras 64%. La prevalencia de factores de riesgo cardiovascular adicionales fue de 83%. El 75% de pacientes hipertensos recibían tratamiento, de los que el 58% tenían presión arterial sistólica ≥140 o diastólica ≥90, a diferencia del 28% de los pacientes sin tratamiento. El porcentaje de individuos según número de fármacos antihipertensivos fue de 21% (0 fármacos), 48% (1 fármaco), 20% (2 fármacos) y 11% (3 fármacos o más). Las cifras de presión arterial eran más elevadas en los pacientes que recibían mayor número de fármacos antihipertensivos. No se hallaron diferencias en función de HTA respecto a edad (64 ± 13 en hipertensos respecto a 60 ± 15 en normotensos), tiempo en diálisis (4 ± 4 frente a 4 ± 4 años), ganancia de peso interdiálisis (2,1 ± 0,8 frente a 2,1 ± 0,8 kg), % de ganancia de peso frente a peso seco (3,3 ± 1,4 frente a 3,1 ± 1,4 %) ni % de pacientes con ganancia de peso > 5% respecto a peso seco (32,5 frente a 27,3%). Mientras el 84% de los pacientes con HTA tenía un factor de riesgo o comorbilidad vasculares adicionales, este valor era de 67% en pacientes sin HTA (p < 0,001). Conclusión: Los pacientes en hemodiálisis tienen una elevada prevalencia de HTA en nuestro medio, y ésta se encuentra controlada de forma subóptima. Las causas de este pobre control pueden ser múltiples, y el peso seco no parece jugar un papel primordial en esta muestra de pacientes prevalentes estables. Debido a la agregación de factores de riesgo vascular en estos pacientes, son necesarias estrategias para mejorar el control de la HTA en los pacientes en hemodiálsis."
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        "resumen" => "SUMMARY Objective: To evaluate the prevalence of hypertension (HT) in prevalent hemodialysis (HD) patients in our region, and to analyze the associated clinical and biochemical variables. Methods: Observational, cross-sectional and multicentric study including a representative sample of prevalent and stable (> 6 months) HD patients from all the HD centers (in and out of Hospitals) in Catalonia, Spain. Clinical and biochemical variables were recorded and predialysis blood pressure (BP) was determined (x3) in each dialysis session during 1 month, as well as the pre/post weight weekly. HT was defined as having at least one of these criteria: a mean (12 determinations) systolic BP 3140 mmHg or diastolic BP 390 mmHg or antihypertensive treatment for at least 3 months. Results: The sample comprised 387 patients from 32 of the 40 centers included, 231 of whom where men, with mean age of 63 ± 14 years. The prevalence of HT in this sample was 67.4%, varying according to the etiology of End-Stage Renal Disease: diabetic 81%, vascular 81%, glomerulonephritis 61%, PKD 52%, unknown and others 64%. The prevalence of additional CV risk factors was 83%. One of each hypertensive 4 patients were treated, of whom 58% had systolic BP 3140 or dyastolic 390, in contrast to 28% of untreated patients. The proportion of individuals according to the number of antihypertensive agents was 21% (no agents), 48% (1 agent), 20% (2 agents), 11% (3 agents). Blood pressure was higher among patients receiving higher number of antihypertensive agents. No differences according HT were found in age (64 ± 13 in hypertensive patients versus 60 ± 15 in normotensives), time on dialysis (4 ± 4 vs 4 ± 4 years), interdialysis weight gain (2.1 ± 0.8 vs 2.1 ± 0.8 kg), proportion of weight gain (3.3 ± 1.4 vs 3.1 ± 1.4%) or proportion of patients with > 5% weight gain with respect to dry weight (32.5 vs 27.3%). While 84% of hypertensive patients had an additional CV risk factor, this value was 67% in the patients without HT (p < 0.001). Conclusion: In HD patients HT has a high prevalence in our region and is poorly controlled. The causes of this poor control may be multiple, and weight gain parameters seem not to be a main factor in these stable patients. Due to the aggregation of risk factors in these patients, strategies in order to improve BP control in HD are mandatory. "
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Hypertension in hemodialysis: prevalence and associated factors in catalonia. The PRESDIAL study
Prevalencia y factores asociados a hipertensión arterial en hemodiálisis en Cataluña. Estudio PRESDIAL
Esteban Poch Nefrologia Hospital Clinic, IDIBAPS, Universidad de Barcelona, Xavier Martínez Medicina Preventiva Hospital Vall Hebron, Jose Angel Rodri
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    "documento" => "article"
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    "cita" => "Nefrologia (English Version). 2006;26:559-63"
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      "titulo" => "Arterial blood pressure variations: homocysteine and nitric oxide synthase gene polymorphisms (NOS3)"
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        "es" => array:1 [
          "titulo" => "Presión arterial, homocisteína y variantes polimórficas del gen de la óxido nítrico sintasa (NOS3)"
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          "autoresLista" => "F.J. Rodríguez Esparragón, J.C. Rodríguez Pérez, A. Macías Reyes, Y. Hernández Trujillo, M. González Leiza, A. Caballero Hidalgo"
          "autores" => array:1 [
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              "nombre" => "F.J. Rodríguez Esparragón, J.C. Rodríguez Pérez, A. Macías Reyes, Y. Hernández Trujillo, M. González Leiza, A. Caballero Hidalgo"
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    "titulo" => "Hypertension in hemodialysis: prevalence and associated factors in catalonia. The PRESDIAL study"
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        "autoresLista" => "Esteban Poch Nefrologia Hospital Clinic, IDIBAPS, Universidad de Barcelona, Xavier Martínez Medicina Preventiva Hospital Vall Hebron, Jose Angel Rodri"
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          0 => array:1 [
            "nombre" => "Esteban Poch Nefrologia Hospital Clinic, IDIBAPS, Universidad de Barcelona, Xavier Martínez Medicina Preventiva Hospital Vall Hebron, Jose Angel Rodri"
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        "resumen" => "Objetivo: Evaluar la prevalencia de hipertensión arterial (HTA) en pacientes en programa de hemodiálisis en Cataluña y analizar los factores clínicos y bioquímicos asociados. Método: Estudio multicéntrico, transversal y observacional que incluyó una muestra representativa de pacientes hemodializados en situación estable (más de 6 meses) de todos los centros de hemodiálisis de Cataluña, tanto hospitalarios como ambulatorios. Se recogieron variables clínicas y bioquímicas basales y se determinó la presión arterial prediálisis (3 determinaciones) en cada sesión durante 1 mes, además de registrarse el peso pre y post-diálisis semanalmente. Se definió HTA como la presencia de uno o más de los siguientes criterios: media (12 determinaciones) de presión arterial sistólica ≥140 mmHg, de presión diastólica ≥90 mmHg o tratamiento antihipertensivo durante al menos 3 meses. Resultados: Se estudiaron 387 pacientes de 32 de los 40 centros, 231 de los cuáles eran varones, con medias de edad de 63 ± 14 años. La prevalencia de HTA en esta muestra fue de 67,4%, que varió de acuerdo con la etiología de la insuficiencia renal crónica terminal: diabética 81%, vascular 81%, glomerulonefritis 61%, poliquistosis 52%, desconocida y otras 64%. La prevalencia de factores de riesgo cardiovascular adicionales fue de 83%. El 75% de pacientes hipertensos recibían tratamiento, de los que el 58% tenían presión arterial sistólica ≥140 o diastólica ≥90, a diferencia del 28% de los pacientes sin tratamiento. El porcentaje de individuos según número de fármacos antihipertensivos fue de 21% (0 fármacos), 48% (1 fármaco), 20% (2 fármacos) y 11% (3 fármacos o más). Las cifras de presión arterial eran más elevadas en los pacientes que recibían mayor número de fármacos antihipertensivos. No se hallaron diferencias en función de HTA respecto a edad (64 ± 13 en hipertensos respecto a 60 ± 15 en normotensos), tiempo en diálisis (4 ± 4 frente a 4 ± 4 años), ganancia de peso interdiálisis (2,1 ± 0,8 frente a 2,1 ± 0,8 kg), % de ganancia de peso frente a peso seco (3,3 ± 1,4 frente a 3,1 ± 1,4 %) ni % de pacientes con ganancia de peso > 5% respecto a peso seco (32,5 frente a 27,3%). Mientras el 84% de los pacientes con HTA tenía un factor de riesgo o comorbilidad vasculares adicionales, este valor era de 67% en pacientes sin HTA (p < 0,001). Conclusión: Los pacientes en hemodiálisis tienen una elevada prevalencia de HTA en nuestro medio, y ésta se encuentra controlada de forma subóptima. Las causas de este pobre control pueden ser múltiples, y el peso seco no parece jugar un papel primordial en esta muestra de pacientes prevalentes estables. Debido a la agregación de factores de riesgo vascular en estos pacientes, son necesarias estrategias para mejorar el control de la HTA en los pacientes en hemodiálsis."
      ]
      "en" => array:1 [
        "resumen" => "SUMMARY Objective: To evaluate the prevalence of hypertension (HT) in prevalent hemodialysis (HD) patients in our region, and to analyze the associated clinical and biochemical variables. Methods: Observational, cross-sectional and multicentric study including a representative sample of prevalent and stable (> 6 months) HD patients from all the HD centers (in and out of Hospitals) in Catalonia, Spain. Clinical and biochemical variables were recorded and predialysis blood pressure (BP) was determined (x3) in each dialysis session during 1 month, as well as the pre/post weight weekly. HT was defined as having at least one of these criteria: a mean (12 determinations) systolic BP 3140 mmHg or diastolic BP 390 mmHg or antihypertensive treatment for at least 3 months. Results: The sample comprised 387 patients from 32 of the 40 centers included, 231 of whom where men, with mean age of 63 ± 14 years. The prevalence of HT in this sample was 67.4%, varying according to the etiology of End-Stage Renal Disease: diabetic 81%, vascular 81%, glomerulonephritis 61%, PKD 52%, unknown and others 64%. The prevalence of additional CV risk factors was 83%. One of each hypertensive 4 patients were treated, of whom 58% had systolic BP 3140 or dyastolic 390, in contrast to 28% of untreated patients. The proportion of individuals according to the number of antihypertensive agents was 21% (no agents), 48% (1 agent), 20% (2 agents), 11% (3 agents). Blood pressure was higher among patients receiving higher number of antihypertensive agents. No differences according HT were found in age (64 ± 13 in hypertensive patients versus 60 ± 15 in normotensives), time on dialysis (4 ± 4 vs 4 ± 4 years), interdialysis weight gain (2.1 ± 0.8 vs 2.1 ± 0.8 kg), proportion of weight gain (3.3 ± 1.4 vs 3.1 ± 1.4%) or proportion of patients with > 5% weight gain with respect to dry weight (32.5 vs 27.3%). While 84% of hypertensive patients had an additional CV risk factor, this value was 67% in the patients without HT (p < 0.001). Conclusion: In HD patients HT has a high prevalence in our region and is poorly controlled. The causes of this poor control may be multiple, and weight gain parameters seem not to be a main factor in these stable patients. Due to the aggregation of risk factors in these patients, strategies in order to improve BP control in HD are mandatory. "
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Article information
ISSN: 20132514
Original language: English
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