Interdialytic 24-Hours Ambulatory Blood Pressure versus Dialysis Unit Blood Pressure for the Diagnosis of Electrocardiographic-Left Ventricular Hypertrophy in Chronic Hemodialysis Black Patients

Cédric Kabemba Ilunga1, François Bompeka Beka Lepira1*, Jean Robert Rissassi Makulo1, Yves Lubenga2, Trésor Mvunzi2, Noel Utshudi2, Aliocha Nkodila3, Vieux Momeme Mokoli1, Ernest Kiswaya Sumaili1, Nazaire Mangani Nseka1, Eleuthère Vita Kintoki2

1Division of Nephrology, Department of Internal Medicine, University of Kinshasa Hospital, Kinshasa, the Democratic Republic
of the Congo
2Division of Cardiology, Department of Internal Medicine, University of Kinshasa Hospital, Kinshasa, the Democratic Republic of
the Congo
3Centre medical cite des Aveugles, Kinshasa, Congo

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Background and Aim: In hemodialysis patients, 24-hours interdialytic ABPM better detects TOD than dialysis unit blood pressure. Therefore, the present study was aimed to assess the diagnostic performance of 24-hours  ABPM vs. dialysis unit BPs for the diagnosis of ECG-LVH in steady state chronic hemodialysis black patients. Methods: From March 31 to September 30, 2018, interdialytic ABPM was performed after a mid-week hemodialysis session for 24 hours using a Spacelab 90207 ABPM monitor in the non-access
arm in 45 stable chronic hemodialysis black patients (age ≥ 20 years, hemodialysis for at least 3 months and informed consent) attending 3 hemodialysis centers in Kinshasa. Ambulatory BP was recorded every 20 minutes during the day (6 AM to 10 PM) and every 30 minutes during the night (10 PM to 6 AM). ECG-LVH was defined using Cornell product criteria.

ROC curve method was used to assess the performance of dialysis unit BPs vs. interdialytic 24-hours ABPM in diagnosing ECG-LVH. P < 0.05 defined the level of statistical significance. Results: Whatever the method of BP measurement, all the SBP values were related to ECG-LVH with similar AUC and overlapping 95% CI; however, they were not significantly different from each other. 24-hours interdialytic ambulatory SBP (AUC 0.748; 95% CI 0.58 – 0.94) had the highest area under the curve. Conclusion: The present study showed that although
all the two BP measurement methods equally detected ECG-LVH, 24-hours
ABPM tended to have the highest diagnostic performance.

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