IMPACTO DA MUDANÇA DE MODALIDADE NA PRESSÃO ARTERIAL DE PACIENTES EM DIÁLISE PERITONEAL

INTRODUCTION: Hypertension is a leading cause of kidney failure, affects most dialysis patients, and associates with adverse outcomes. Hypertension can be difficult to control with dialysis modalities having differential effects on sodium and water removal. There are two main types of peritoneal dialysis (PD), automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD). It is unknown whether one is superior to the other in controlling blood pressure (BP). AIMS: The aim of our study was to analyze the impact of switching between these two PD modalities on BP levels in a nationally representative cohort. MATERIALS AND METHODS: This was a cohort study of patients on PD from 122 dialysis centers in Brazil. Clinical and laboratory data were collected monthly throughout the study duration. We selected all patients who switched PD modality and remained on PD at least 6 months, with 3 months on each modality. We compared the changes in mean systolic/diastolic blood pressures (SBP/DBP) before and after modality transition RESULTS: We analyzed data of 848 patients (814 starting on CAPD and 34 starting on APD). The SBP decreased by 4.4 mmHg when transitioning from CAPD to APD and increased by 3.6 mmHg when transitioning from APD to CAPD; consistent findings were seen for DBP. There was no significant change in the number of antihypertensive drugs prescribed before and after transition. FINAL CONSIDERATIONS: Transition between PD modalities seems to directly impact on BP levels. Further studies are needed to confirm if switching to APD could be an effective treatment for uncontrolled hypertension among CAPD patients.

KEYWORDS: Chronic kidney disease; Systemic arterial hypertension; CAPD; APD; Multicenter study.