Vnitr Lek 2003, 49(4):263-266

[Ambulatory monitoring of blood pressure in regular dialysis therapy].

J Erben, V Panácek, J Procházka: Interní a nefrologické oddĕlení políkliniky, Pardubice.

Ambulatory monitoring of the blood pressure (AMBP) makes it possible to diagnose in hypertensive patients the so-called dipper phenomenon, i.e. a drop of the BP during the night provided that the patient is asleep. The absence of this phenomenon implies as a rule serious damage of the cardiovascular apparatus, brain or kidneys. By means of an apparatus ABP monitoring type 90207 of Space Labs. Inc. a group of 16 patients in regular dialysis treatment (RDT) was examined and the blood pressures were evaluated before and after dialysis. Patients with the dipper profile reacted more adequately during dialysis i.e. by a drop of the blood pressure due to the loss of excessive fluid which they retained during the interdialysis period, as compared with the group with a non-dipper profile which may be exposed to a greater risk of cardiovascular complications. The authors conclude that detection of the absence of the non-dipper phenomenon can reveal risk patients. AMBP can explain so-called paradoxical hypertension at the end of haemodialysis despite major removal of fluids by ultrafiltration, and that moxonidine participates in a significant way in the elimination of the non-dipper phenomenon.