Introduction:
End stage kidney disease (ESKD) patients on haemodialysis exhibit altered circadian rhythm of melatonin in blood leading to sleep disturbances. Recent studies show that Loss of normal nocturnal decline in blood pressure is usually associated with increased risk of cardiovascular complications and poor renal outcomes. This can only detected by Ambulatory blood pressure monitoring (ABPM) Very less attention paid to quality of life/sleep disturbances in ESKD patients.
Methods:
AIM
To study ABPM profile in ESKD patients on Maintenance Haemodialysis (MHD) with sleep disturbances
METHODS
This was a single centre prospective observational study in a tertiary care centre in South India from May 2024 to August 2024. Patients undergoing MHD with a minimum Dialysis vintage of 12 months with baseline Pittsburgh Sleep Quality Index (PQSI) >5 were selected. 24 hour ABPM was recorded on the day prior to dialysis. Nocturnal dip in blood pressure, Early morning BP surge, Blood pressure variability were analysed.
Results:
98 patients undergoing MHD >12 months were studied. A total of 30 patients fulfilled PQSI >5 criteria for sleep disturbance (30.6%). Study population included 22 males(73%) and 8 females (27%). Median age of study group was 45 years. 11 (36%) of patients were non- dippers (systolic BP fall 0-10% during 12 AM - 6 AM from baseline). 12 (40%) of patients were reverse dippers (BP rise at 12 AM- 6 AM). 7 (23%) were dippers (systolic BP fall >10% during 12 AM - 6 AM from baseline).
20(66%) of our study population had early morning BP surge (systolic BP>20 mm Hg as cut-off based on prior studies).
Conclusions:
Our study showed significantly higher prevalence of Nocturnal hypertension and early morning BP surge which are well known risk factors for adverse outcomes. Our study emphasizes importance of studying sleep quality in ESKD patients in MHD units. ABPM in selected populations helps monitor and achieve tight BP control in these patients.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.