Key result
During hemodialysis, 30.9% of patients experienced intradialytic hypertension and 19.8% experienced intradialytic hypotension, with hypertension being significantly more common in those with hypertensive nephropathy.
Observational (n=217)
No
Intradialytic hypertension and hypotension are common during hemodialysis, with distinct risk profiles based on the underlying cause of kidney disease.
Intradialytic BP instability is frequent in hemodialysis and varies by etiology; supports closer monitoring but leaves open whether etiology-specific interventions improve outcomes.
BACKGROUND: Blood pressure (BP) variation is commonly encountered during hemodialysis (HD) procedure. Both intradialysis hypotension and hypertension have implications for outcome of treatment and overall morbidity and mortality of the patients. METHODOLOGY: A retrospective study was carried out in the dialysis unit of a tertiary health institution in Benin City among patients who had HD for acute kidney injury (AKI) or chronic kidney disease (CKD) over a 3-year period. Data retrieved included age, gender, type of kidney disease, cause of kidney disease, systolic BP at onset of dialysis and at end of dialysis, and diastolic BP (DBP) at onset of and at end of dialysis. RESULTS: Complete data were available for 217 patients. One hundred and seven patients (49.3%) had no significant change in BP; 30.9% had intradialytic hypertension (IDHT) while 19.8% had intradialytic hypotension (IDH). IDH was more prevalent among patients with diabetic kidney disease while IDHT was more common among patients with hypertensive nephropathy (P = 0.002). Female patients had higher mean BP parameters compared to male patients pre- and post-dialysis, but only changes in DBP were statistically significant (P = 0.029). Patients with CKD had higher mean BP parameters pre- and post-dialysis compared to patients with acute AKI and the differences were statistically significant. CONCLUSION: Females had higher mean BP parameters than males. Patients with CKD had higher mean BP parameters compared with AKI patients. IDHT is a significant problem among patients on HD in our center. Measures to curtail this trend should be instituted with the goal of reducing morbidity and mortality.
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Okaka et al. (2017) conducted an observational in Renal failure (Acute kidney injury or chronic kidney disease) requiring hemodialysis (n=217). Hemodialysis was evaluated on Blood pressure variation during hemodialysis (intradialytic hypotension and hypertension). During hemodialysis, 30.9% of patients experienced intradialytic hypertension and 19.8% experienced intradialytic hypotension, with hypertension being significantly more common in those with hypertensive nephropathy.
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