Periton Diyaliz Hastalarında Postprandiyal Hipotansiyon ve Karotid İntima Kalınlığının Arasındaki İlişkinin Değerlendirilmesi
Öz
Amaç: Postprandiyal hipotansiyon, senkop ve düşmelerin yaygın bir nedeni olarak kabul edilmektedir. Bu çalışmada, periton diyalizi hastalarında postprandiyal hipotansiyon sıklığını belirlemeyi ve karotid intima kalınlığı ile olan ilişkisini araştırmayı amaçladık.
Gereç ve Yöntem: Çalışma, Hatay Eğitim ve Araştırma Hastanesi Periton Diyalizi Merkezi'nde yürütülmüş olup, retrospektif tasarıma sahip bir araştırmadır. Çalışmaya toplam 28 periton diyalizi hastası dahil edildi. Çalışmaya 18 yaşından büyük ve en az üç aydır periton diyalizi yapılan hastalar dahil edildi. Hastalara ambulatuvar kan basıncı holter cihazı takıldı ve karotid doppler yapıldı.
Bulgular: Çalışmaya toplam 28 hasta dahil edildi. Hastaların yaş ortalaması 48 ±14,04 (18-68 arası) idi. Hastaların 14'ü erkek, 14'ü kadındı. Ortalama sistolik kan basıncı 131.2±23,4 mmHg (81-178 arası), ortalama diyastolik kan basıncı ise 75,7±14,2 mmHg (48-99 arası) idi. 12 hastada ambulatuvar kan basıncı normal, 16 hastada ise hipertansiyon saptandı. Hastaların 25'inde (%89,3) hipertansiyon mevcuttu. Toplam 26 hastada karotid intima kalınlığı incelendi ve hastaların %35,7’sinde (10 hasta) kalınlık tespit edildi. Postprandiyal hipotansiyon altı hastada (%21,4) saptandı. Postprandiyal hipotansiyon olan tüm hastaların hipertansiyon öyküsü vardı.
Sonuç: Çalışmamızda hipertansiyon prevalansı %89,3 olarak bulundu. Postprandiyal hipotansiyon sıklığı %21,4 idi. Hastaların %35,7'sinde (26 hastadan) karotid intima kalınlığı artışı saptandı. Postprandiyal hipotansiyon ile karotid intima kalınlığı arasında bir ilişki tespit edilmedi.
Anahtar Kelimeler
Karotid İntima Kalınlaşması Hipertansiyon Periton Diyalizi Postprandiyal Hipotansiyon
Kaynakça
- Vaios V, Georgianos PI, Liakopoulos V, Agarwal R. Assessment and management of hypertension among patients on peritoneal dialysis. CJASN. 2019;14(2):297-305. doi: 10.2215/CJN.07480618
- Vaios V, Georgianos PI, Vareta G, Dounousi E, Dimitriadis C, Eleftheriadis T, et al. Clinic and home blood pressure monitoring for the detection of ambulatory hypertension among patients on peritoneal dialysis. Hypertension, 2019;74(4): 998-1004. doi: 10.1161/HYPERTENSIONAHA.119.13443.
- Sarafidis PA, Persu A, Agarwal R, Burnier M, De Leeuw P, Ferro CJ, et al. Hypertension in dialysis patients: a consensus document by the European Renal and Cardiovascular Medicine (EURECA-m) working group of the European Renal Association–European Dialysis and Transplant Association (ERA-EDTA) and the Hypertension and the Kidney working group of the European Society of Hypertension (ESH). ndt. 2017;32(4):620-40. https://doi.org/10.1093/ndt/gfw433
- Puisieux F. Postprandial hypotension in the elderly. Presse Medicale (Paris, France: 1983). 2003;32(26):1226-1230.
- Jansen RW, Hoefnagels WH. Postprandial blood pressure reduction. Neth J Med. 1990;37(1-2):80-8.
- Homa S, Nobuyoshi H, Ishida H, Ishii T, Araki G. Carotid plaque and intima-media thickness assessed by B-mode sonography in subjects ranging from young adults to centenarians. Stroke. 2001;32:830-35. doi: 10.1161/01.str.32.4.830.
- Gürsu M, Aydın Z, Uzun S, Karadağ S, Oğullar S, Kiriş A, et al. Böbrek yetersizliğinin farklı evrelerinde karotis intima media kalınlıklarının değerlendirilmesi. Turkish J Nephrol. 2012;21(3):228-34. doi: 10.5262/tndt. 2012.1003.05
- Samaras D, Carmona G, Vischer U, Perrenoud JJ. Postprandial hypotension: an unclear clinical entity. Rev Med Suisse. 2006;2(85):2456-8.
- O'Mara G, Lyons D. Postprandial hypotension. Clin Geriatr Med. 2002;18(2): 307-21. doi: 10.1016/s0749-0690(02)00012-5.
- Rhebergen GA, Schölzel-Dorenbos CJ. Orthostatic and postprandial hypotension in patients aged 70 years or older admitted to a medical ward. Tijdschr Gerontol Geriatr. 2002;33(3):119-23.
- Jang A. Postprandial hypotension as a risk factor for the development of new cardiovascular disease: a prospective cohort study with 36 month follow-up in community-dwelling elderly people. JCM. 2020;9(2): 345. doi: 10.3390/jcm9020345.
- Fisher AA, Davis MW, Srikusalanukul W, Budge MM. Postprandial hypotension predicts all cause mortality in older, low level care residents. J Am Geriatr Soc. 2005;53(8):1313-20. doi: 10.1111/j.1532-5415.2005.53415.x.
- Aronow WS, Ahn C. Association of postprandial hypotension with incidence of falls, syncope, coronary events, stroke, and total mortality at 29 month follow up in 499 older nursing home residents. J Am Geriatr Soc. 1997;45(9):1051-53. doi: 10.1111/j.1532-5415.1997.tb05965.x.
- Ortega LM, Materson BJ. Hypertension in peritoneal dialysis patients: epidemiology, pathogenesis, and treatment. J Am Soc Hypertens. 2011;5(3):128-36. doi: 10.1016/j.jash.2011.02.004.
- Vareta G, Georgianos PI, Vaios V, Sgouropoulou V, Roumeliotis S, Georgoulidou A, et al. Epidemiology of Hypertension among Patients on Peritoneal Dialysis Using Standardized Office and Ambulatory Blood Pressure Recordings. Am J Nephrol (2022) 53 (2-3): 139–147. https://doi.org/10.1159/000521861
- Davies S, Haraldsson B, Vrtovsnik F, Schwenger V, Fan S, Klein A, et al. Single-dwell treatment with a low-sodium solution in hypertensive peritoneal dialysis patients. Perit Dial Int. 2020;40(5):446-54. doi: 10.1177/0896860820924136.
- Wang AYM, Brimble KS, Brunier G, Holt SG, Jha V, Johnson DW, et al. ISPD cardiovascular and metabolic guidelines in adult peritoneal dialysis patients part I–assessment and management of various cardiovascular risk factors. PDI. 2015;35(4):379-87.
- Flythe JE, Chang TI, Gallagher MP, Lindley E, Madero M, Sarafidis PA, et al. Blood pressure and volume management in dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int. 2020;97(5):861-76. doi: 10.1016/j.kint.2020.01.046.
- Luciano GL, Brennan MJ, Rothberg MB. Postprandial hypotension. Am J Med. 2010;123(3):281-e1. doi: 10.1016/j.amjmed.2009.06.026.
- Trahair LG, Horowitz M, Jones KL. Postprandial hypotension: a systematic review. J Am Med Dir Assoc. 2014;15(6):394-09. doi: 10.1016/j.jamda.2014.01.011.
- Park JW, Okamoto LE, Shibao CA, Biaggioni I. Pharmacologic treatment of orthostatic hypotension. Auton Neurosci. 2020;229:102721. doi: 10.1016/j.autneu.2020.102721.
- Jenkins DJ, Sahye-Pudaruth S, Khodabandehlou K, et al. Systematic review and meta-analysis examining the relationship between postprandial hypotension, cardiovascular events, and all-cause mortality. Am J Clin Nutr. 2022;116:663-71. doi: 10.1093/ajcn/nqac158.
- Abbas R, Tanguy A, Bonnet-Zamponi D, Djedid R, Lounis A, Gaubert-Dahan ML. New simplified screening method for postprandial hypotension in older people. J Frailty Aging. 2018;7(1):28-33 doi: 10.14283/jfa.2018.2. PMID: 29412439.
Evaluation of the Relationship Between Postprandial Hypotension and Carotid Intima Thickness in Peritoneal Dialysis Patients/ Periton Diyaliz Hastalarında Postprandiyal Hipotansiyon ve Karotid İntima Kalınlığının Arasındaki İlişkinin Değerlendirilmesi
Öz
Aim: Postprandial hypotension is recognized as a common cause of syncope and falls. This study aimed to determine the frequency of postprandial hypotension in patients undergoing peritoneal dialysis and to investigate the relationship between postprandial hypotension and carotid intima thickness.
Materials and Methods: The study was conducted at the Peritoneal Dialysis Unit of Hatay Training and Research Hospital and was designed as a retrospective study. A total of 28 patients on peritoneal dialysis were included. Inclusion criteria were patients older than 18 years of age who had been on peritoneal dialysis for at least three months. Patients wore an ambulatory blood pressure Holter device, and carotid Doppler ultrasonography was performed.
Results: The study included 28 patients with a mean age of 48 ± 14.04 years (range: 18–68); 14 were male and 14 were female. The mean systolic blood pressure was 131.2 ± 23.4 mmHg (range: 81–178), and the mean diastolic blood pressure was 75.7 ± 14.2 mmHg (range: 48–99). Ambulatory blood pressure was normal in 12 patients, while 16 patients were hypertensive. Hypertension was present in 25 patients (89.3%). Carotid intima thickness was evaluated in 26 patients, and increased thickness was detected in 10 of them (35.7%). Postprandial hypotension was observed in six patients (21.4%), all of whom had a history of hypertension.
Conclusion: In this study, the prevalence of hypertension was 89.3%, and the frequency of postprandial hypotension was 21.4%. Increased carotid intima thickness was identified in 35.7% of the patients. No significant correlation was observed between postprandial hypotension and carotid intima thickness.
Anahtar Kelimeler
Carotid Intima Thickness Hypertension Peritoneal Dialysis Postprandial Hypotension
Etik Beyan
The approval of the ethics committee for this study was obtained from the Ethics Committee of Mustafa Kemal University (Date and no: 12.10.2023; 19).
Kaynakça
- Vaios V, Georgianos PI, Liakopoulos V, Agarwal R. Assessment and management of hypertension among patients on peritoneal dialysis. CJASN. 2019;14(2):297-305. doi: 10.2215/CJN.07480618
- Vaios V, Georgianos PI, Vareta G, Dounousi E, Dimitriadis C, Eleftheriadis T, et al. Clinic and home blood pressure monitoring for the detection of ambulatory hypertension among patients on peritoneal dialysis. Hypertension, 2019;74(4): 998-1004. doi: 10.1161/HYPERTENSIONAHA.119.13443.
- Sarafidis PA, Persu A, Agarwal R, Burnier M, De Leeuw P, Ferro CJ, et al. Hypertension in dialysis patients: a consensus document by the European Renal and Cardiovascular Medicine (EURECA-m) working group of the European Renal Association–European Dialysis and Transplant Association (ERA-EDTA) and the Hypertension and the Kidney working group of the European Society of Hypertension (ESH). ndt. 2017;32(4):620-40. https://doi.org/10.1093/ndt/gfw433
- Puisieux F. Postprandial hypotension in the elderly. Presse Medicale (Paris, France: 1983). 2003;32(26):1226-1230.
- Jansen RW, Hoefnagels WH. Postprandial blood pressure reduction. Neth J Med. 1990;37(1-2):80-8.
- Homa S, Nobuyoshi H, Ishida H, Ishii T, Araki G. Carotid plaque and intima-media thickness assessed by B-mode sonography in subjects ranging from young adults to centenarians. Stroke. 2001;32:830-35. doi: 10.1161/01.str.32.4.830.
- Gürsu M, Aydın Z, Uzun S, Karadağ S, Oğullar S, Kiriş A, et al. Böbrek yetersizliğinin farklı evrelerinde karotis intima media kalınlıklarının değerlendirilmesi. Turkish J Nephrol. 2012;21(3):228-34. doi: 10.5262/tndt. 2012.1003.05
- Samaras D, Carmona G, Vischer U, Perrenoud JJ. Postprandial hypotension: an unclear clinical entity. Rev Med Suisse. 2006;2(85):2456-8.
- O'Mara G, Lyons D. Postprandial hypotension. Clin Geriatr Med. 2002;18(2): 307-21. doi: 10.1016/s0749-0690(02)00012-5.
- Rhebergen GA, Schölzel-Dorenbos CJ. Orthostatic and postprandial hypotension in patients aged 70 years or older admitted to a medical ward. Tijdschr Gerontol Geriatr. 2002;33(3):119-23.
- Jang A. Postprandial hypotension as a risk factor for the development of new cardiovascular disease: a prospective cohort study with 36 month follow-up in community-dwelling elderly people. JCM. 2020;9(2): 345. doi: 10.3390/jcm9020345.
- Fisher AA, Davis MW, Srikusalanukul W, Budge MM. Postprandial hypotension predicts all cause mortality in older, low level care residents. J Am Geriatr Soc. 2005;53(8):1313-20. doi: 10.1111/j.1532-5415.2005.53415.x.
- Aronow WS, Ahn C. Association of postprandial hypotension with incidence of falls, syncope, coronary events, stroke, and total mortality at 29 month follow up in 499 older nursing home residents. J Am Geriatr Soc. 1997;45(9):1051-53. doi: 10.1111/j.1532-5415.1997.tb05965.x.
- Ortega LM, Materson BJ. Hypertension in peritoneal dialysis patients: epidemiology, pathogenesis, and treatment. J Am Soc Hypertens. 2011;5(3):128-36. doi: 10.1016/j.jash.2011.02.004.
- Vareta G, Georgianos PI, Vaios V, Sgouropoulou V, Roumeliotis S, Georgoulidou A, et al. Epidemiology of Hypertension among Patients on Peritoneal Dialysis Using Standardized Office and Ambulatory Blood Pressure Recordings. Am J Nephrol (2022) 53 (2-3): 139–147. https://doi.org/10.1159/000521861
- Davies S, Haraldsson B, Vrtovsnik F, Schwenger V, Fan S, Klein A, et al. Single-dwell treatment with a low-sodium solution in hypertensive peritoneal dialysis patients. Perit Dial Int. 2020;40(5):446-54. doi: 10.1177/0896860820924136.
- Wang AYM, Brimble KS, Brunier G, Holt SG, Jha V, Johnson DW, et al. ISPD cardiovascular and metabolic guidelines in adult peritoneal dialysis patients part I–assessment and management of various cardiovascular risk factors. PDI. 2015;35(4):379-87.
- Flythe JE, Chang TI, Gallagher MP, Lindley E, Madero M, Sarafidis PA, et al. Blood pressure and volume management in dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int. 2020;97(5):861-76. doi: 10.1016/j.kint.2020.01.046.
- Luciano GL, Brennan MJ, Rothberg MB. Postprandial hypotension. Am J Med. 2010;123(3):281-e1. doi: 10.1016/j.amjmed.2009.06.026.
- Trahair LG, Horowitz M, Jones KL. Postprandial hypotension: a systematic review. J Am Med Dir Assoc. 2014;15(6):394-09. doi: 10.1016/j.jamda.2014.01.011.
- Park JW, Okamoto LE, Shibao CA, Biaggioni I. Pharmacologic treatment of orthostatic hypotension. Auton Neurosci. 2020;229:102721. doi: 10.1016/j.autneu.2020.102721.
- Jenkins DJ, Sahye-Pudaruth S, Khodabandehlou K, et al. Systematic review and meta-analysis examining the relationship between postprandial hypotension, cardiovascular events, and all-cause mortality. Am J Clin Nutr. 2022;116:663-71. doi: 10.1093/ajcn/nqac158.
- Abbas R, Tanguy A, Bonnet-Zamponi D, Djedid R, Lounis A, Gaubert-Dahan ML. New simplified screening method for postprandial hypotension in older people. J Frailty Aging. 2018;7(1):28-33 doi: 10.14283/jfa.2018.2. PMID: 29412439.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Dahili Hastalıklar Hemşireliği |
| Bölüm | Makale |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Mayıs 2025 |
| Gönderilme Tarihi | 22 Aralık 2024 |
| Kabul Tarihi | 18 Mart 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 20 Sayı: 2 |
Kaynak Göster
Nefroloji Hemşireliği Dergisi/ Journal of Nephrology Nursing 
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