Towards improved cardiovascular management: the necessity of combining blood pressure and fluid overload

Background. Hypertension and fluid overload (FO) are well-recognized problems in the chronic kidney disease (CKD) population. While the prevalence of hypertension is well documented, little is known about the severity of FO in this population. Methods. A new bioimpedance spectroscopy device (BCM—Body Composition Monitor) was selected that allows quantitative determination of the deviation in hydration status from normal ranges (ΔHS). Pre-dialysis systolic blood pressure (BPsys) and ΔHS was analysed in 500 haemodialysis patients from eight dialysis centres. A graphical tool (HRP—hydration reference plot) was devised allowing ΔHS to be combined with measurements of BPsys enabling comparison with a matched healthy population (n = 1244). Results. Nineteen percent of patients (n = 95) were found to have normal BPsys and ΔHS in the normal range. Approximately one-third of patients (n = 133) exhibited reasonable control of BPsys and fluids (BPsys 2.5 L (possible volume-dependent hypertension). In contrast, 13% of patients (n = 69) were hypertensive with ΔHS