Zhang H, Preciado P, Wang Y, et al. - Given that previous studies have shown a link of predialysis systolic blood pressure (pre-HD SBP) and peridialytic SBP change with morbidity and mortality in hemodialysis (HD) patients, but there is lack of good understanding of the nature of their interaction, therefore, researchers performed this study with HD patients treated in US Fresenius Medical Care facilities, to examine pre-HD SBP and peridialytic SBP change (calculated as post-HD SBP minus pre-HD SBP) between January 2001 and December 2012 in this patient population. The study sample comprised 172,199 patients, with a mean age of 62.1 years, including 61.6% white and 55% male. A median follow-up of 25.0 months revealed the deaths of 73,529 patients (42.7%). They observed higher mortality in relation to a peridialytic SBP rise combined with high pre-HD SBP. In contrast, when concurrent with low pre-HD SBP, a peridialytic SBP increase was found to be related to better survival. Findings revealed that the link of pre-HD and peridialytic SBP change with death was complex. A joint, not isolated, interpretation of pre-HD SBP and peridialytic SBP change is needed.