METHODS
The current study was planned as a cross-sectional observational study that included eighty ESRD patients >18 years on a regular dialysis program for at least six months, and forty healthy subjects. Patients were recruited from the dialysis unit of the XXXX Hospital, between January 2020 and June 2020. Those undergoing dialysis were grouped as follows: forty patients on PD and forty patients on HD with AVF. Patients undergoing HD were receiving standard bicarbonate HD sessions three times per week, lasting four hours. Every participant provided informed consent. The study was conducted in accordance with the Declaration of Helsinki and approved by the local Ethics Committee (2019-398).
Clinical or echocardiographic evidence of ischemic heart disease, left ventricular systolic dysfunction with an ejection fraction (EF) of less than 55%, valvulopathy, left bundle branch block, atrial fibrillation, previous renal transplantation were accepted as exclusion criteria. Any clinical condition that might predispose the patient to pulmonary hypertension (chronic obstructive pulmonary disease, interstitial lung diseases, connective tissue disorders, chronic thromboembolic disease, congenital left-to-right shunt, primary pulmonary hypertension), was also a criterion for exclusion.
All of the patients were subjected to a comprehensive clinical evaluation. Blood pressure (BP) was measured after at least 10-minutes rest in a sitting position. The mean of three measurements of each patient was recorded. Patients were defined as having hypertension (HT) if their SBP was >140 mmHg, their DBP was >90 mmHg, or they were using an antihypertensive medication.8 Diabetes was defined by treatment with anti-diabetic medications. Body mass index (BMI) was calculated as body weight divided by height squared (kg/m2). Body surface area (BSA; in m2) was calculated as 0.0061 x height (cm) + 0.0124 x weight (kg) – 0.0099.