Why the study?
Intradialytic hypertension and hypotension are common complications in ESKD patients on maintenance hemodialysis, and their association with BP medications required assessment.
Does antihypertensive medication use affect intradialytic hypertension and hypotension in patients with ESKD undergoing maintenance hemodialysis?
Does antihypertensive medication use affect intradialytic hypertension and hypotension in patients with ESKD undergoing maintenance hemodialysis?
While certain antihypertensive classes like beta-blockers and calcium channel blockers were associated with fewer intradialytic hypertension events, the results were inconclusive due to wide confidence intervals, highlighting the need for larger studies.
Should not yet change antihypertensive prescribing in ESKD; leaves open whether beta-blockers or CCBs reduce intradialytic hypertension events.
<ns3:p>Background In patients with end-stage kidney disease (ESKD) undergoing maintenance hemodialysis, intradialytic hypertension and intradialytic hypotension are the common complications. The study aimed to collect and assess intradialytic Blood Pressure (BP) complications and their association with BP medications. Methods This was a prospective observational study, conducted at the hemodialysis center in a teaching hospital in the UAE, that provide a specialist’s care for the patients receiving ongoing hemodialysis. Patient demographics, medications used, lab data and the peridialytic BP (pre-, intra-, and post-) dialytic BP were collected for a period of 6 months. SPSS Version 29, Armonk, NY was used for statistical analysis. Pearson Chi-square test and Fischer’s Exact test were used to compare the association between categorical variables to intradialytic hypertension and hypotension. Binary logistic regression was used to find the effect of predictive variables to the presence or absence of intradialytic complications. Results Blood pressure data was collected from 47 hemodialysis patients for a total of 2616 hemodialysis sessions during the 6 months study period. Non-dialysable antihypertensives were predominantly used. Beta-blockers (68%) and calcium channel blockers (66%) were the commonly used drug classes. Intradialytic hypertension events were diagnosed in 49 (1.9%) hemodialysis sessions and intradialytic hypotension was diagnosed in 23 (0.9%) hemodialysis sessions. Chi-square test showed association of antihypertensive medication use to the occurrence of intradialytic hypertension; especially ARBs, and alpha-1 blockers. Beta-blockers and calcium channel blockers use were associated with decreased number of intradialytic hypertension events (p-value <0.05). Regression showed broad confidence intervals. On the other hand, antihypertensive medication use showed no association with intradialytic hypotension. Conclusions Even though antihypertensive medications showed varying occurance of intradialytic hypertension, the results are inconclusive due to large confidence intervals that could be due to the presence of colliniarity between the variables. Future studies are required in larger populations.</ns3:p>
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Sherif et al. (2025) studied this question.
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