Is Ambulatory Blood Pressure Monitoring Required for Elderly Hemodialysis Patients during the Interdialytic Period? - Experience of a Tertiary Care Center in South India.

Introduction: Hypertension (HT) is a common and challenging problem in patients on dialysis. Routine peri-dialytic blood pressure (BP) recordings are unable to diagnose HT accurately and stratify cardiovascular risk. We report here an analysis of 2 years, single-center experience on 24-hour ambulatory blood pressure monitoring (ABPM) in elderly hemodialysis patients in the interdialytic period. Materials and Methods: Data of all the patients above 65 years of age undergoing hemodialysis between November 2017 and December 2019 in our hemodialysis unit and for whom 24-hour ABPM was done were collected. Demographics, clinical profile, pre- and post-dialysis BP recordings, 24-hour ABPM characteristics, and the outcome status were analyzed. Results: Of the 37 patients, 28 (75.7%) were males with a mean age of 67.73 years; 67.6% were diabetic. HT was found in all patients (100%), and uncontrolled HT was noted in 30 (81%) patients by ABPM. Patients with uncontrolled HT were also nondippers of BP (100%). A significant association was observed between nondippers and coronary artery disease ( Conclusion: The prevalence of uncontrolled HT with blunted circadian rhythm was high as detected by ABPM in the interdialytic period among elderly hemodialysis patients and had a significant impact on mortality. Masked uncontrolled HT as measured by ABPM was not uncommon in patients with normal peridialytic BP.