Key result
The prevalence of intradialytic hypertension varied from 11% to 57% depending on the definition used, and was significantly predicted by diabetes mellitus, undernutrition, inter-dialytic weight gain >3 kg, and dialysis vintage >3 years.
Why the study?
Intradialytic hypertension is associated with significant vascular and cardiac adverse outcomes, prompting this study to determine its prevalence and predictive factors.
Cross-Sectional (n=136)
No
Intradialytic hypertension is highly prevalent among hemodialysis patients, varies significantly depending on the definition used, and is strongly associated with diabetes, undernutrition, high interdialytic weight gain, and longer dialysis vintage.
IDH prevalence varies by definition with associations to modifiable factors in HD; hypothesis-generating and should not yet change practice.
Introduction: Intradialytic hypertension (IDH) is associated with significant vascular and cardiac adverse outcomes. Objectives: This study was performed to know the prevalence and factors predicting IDH. Patients and Methods: A single-center cross-sectional observational study at a tertiary care hospital. After ethics committee approval and informed consent, all patients over 18 years on twice weekly hemodialysis were included, those on peritoneal dialysis and acute kidney injury excluded. Primary outcome was prevalence of IDH based on three definitions and secondary outcome was predictive factors. IDH was defined as ≥10 mm Hg surge in systolic blood pressure (SBP) between pre-and postdialysis in 4 of 6 successive sessions or >15 mm Hg rise in mean arterial pressure (MAP) between start and end of dialysis or symptomatic rise in blood pressure requiring intervention. SBP and MAP were measured on standardized monitors before, hourly and 30 minutes post dialysis. Results: Of 136 patients, prevalence of intra-dialytic hypertension was 78/136 (57%), 33/136 (24%), 15/136 (11%) based on systolic rise, rise in MAP and symptomatic rise in BP respectively. Among those with systolic rise, diabetes mellitus (P= 0.03), undernourishment (P=0.03), inter-dialytic weight gain >3 kg (P< 0.001) and dialysis vintage > 3 years (P< 0.001) were significantly associated with IDH. Conclusion: IDH prevalence varied from 11 to 57% with different definitions. Diabetes mellitus, under nutrition, inter-dialytic weight gain >3 kg and dialysis vintage >3 years predicted IDH.
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Prabhu et al. (2021) conducted a cross-sectional in Intradialytic hypertension in hemodialysis patients (n=136). Risk factors for intradialytic hypertension vs. Patients without these risk factors was evaluated on Prevalence of intradialytic hypertension based on ≥10 mm Hg increase in SBP between pre- and post-dialysis in at least 4 of 6 successive sessions. The prevalence of intradialytic hypertension varied from 11% to 57% depending on the definition used, and was significantly predicted by diabetes mellitus, undernutrition, inter-dialytic weight gain >3 kg, and dialysis vintage >3 years.
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