Cureus. 2026 Apr 18;18(4):e107282. doi: 10.7759/cureus.107282. eCollection 2026 Apr.
ABSTRACT
Left ventricular hypertrophy (LVH) is common in patients with end-stage renal disease (ESRD) receiving chronic hemodialysis (HD) and is associated with adverse cardiovascular outcomes. Pre-dialysis blood pressure (BP) is routinely measured, but the association of a single in-unit BP compared with longer-term averages remains unclear. In this prospective observational study conducted at the Dialysis Center in Doboj (June-September 2017), 97 chronic HD patients (≥5 months on HD) underwent standardized pre-dialysis BP measurements three times weekly over two months and transthoracic echocardiography. Single BP was defined as the mid-week pre-dialysis measurement, while the two-month average BP represented the mean of all pre-dialysis measurements. Volume overload was estimated clinically from pre-dialysis weight relative to dry weight and averaged over two months. Associations between BP metrics and left ventricular mass index (LVMI) were assessed using linear and multivariable regression adjusted for age, hemoglobin, and two-month average volume overload. Receiver operating characteristic (ROC) analysis evaluated the two-month average systolic BP (SBP) for LVH discrimination. Among the participants (mean age: 58 ± 12 years), LVH was present in 44/97 (45%). Single pre-dialysis SBP and all diastolic BP (DBP) measures were not significantly associated with LVMI. In contrast, two-month average pre-dialysis SBP was independently associated with LVMI (β = 0.3847, p = 0.0433). A two-month average SBP cutoff of > 150 mmHg discriminated LVH (area under the curve (AUC) 0.619, 95% confidence interval (CI): 0.515-0.717; p = 0.039), with 70.45% sensitivity and 55.77% specificity; SBP > 150 mmHg was associated with higher odds of LVH (odds ratio (OR): 3.11, 95% CI: 1.34-7.24). These findings support longitudinal assessment of pre-dialysis SBP, which was associated with higher LVMI/LVH in this cohort.
PMID:42158767 | PMC:PMC13182453 | DOI:10.7759/cureus.107282