Key result
Intradialytic hypertension affects ~41% of hemodialysis patients, linked to vascular nephropathy and polypharmacy.
Why the study?
Intradialytic hypertension is a recurring and persistent phenomenon in some hemodialysis patients and is associated with increased hospitalization and death risk, but its prevalence and associated factors in Guinea were not determined.
Cross-Sectional (n=131)
No
Intradialytic hypertension is highly prevalent (40.5%) among chronic hemodialysis patients in Guinea and is associated with factors such as pre-dialytic hypertension, high ultrafiltration rate, and vascular nephropathy.
Common in hemodialysis; hypothesis-generating associations require prospective validation before informing practice.
Introduction: Dialytic high blood pressure (DHBP), although often ignored, is now recognized as a recurring and persistent phenomenon in a subgroup of hemodialysized patients. Its occurrence is associated with an increased risk of hospitalization and death. The objective of the study was to determine the prevalence of intradialytic hypertension and the factors associated with it. Methods: Study was cross-sectional, monocentric, descriptive and analytical over a three-month period from April 22 to July 22, 2019. Included were all patients 18 years of age or older, chronic hemodialysis for at least three months, with intra-dialytic high blood pressure. The blood pressure machine used for the majority of patients was an electronic “OMRON” blood pressure monitor. Epidemiological, clinical, para clinical and dialysis parameters were studied. The data were collected, captured and analyzed using IBM SPSS Statistics Version 20 software. The factors associated with intradialytic high blood pressure were searched using a univariate logistic regression model. The significance threshold for all statistical tests has been set at 5%. Results: Of our 131 patients, 53 had intradialytic hypertension, a frequency of 40.5%. The time of (DHBP) occurrence was more frequent at the 3rd and 2nd hour, 94.34% and 86.79%, respectively. The average age of patients was 45.51 years with extremes ranging from 19 to 70 years. The average Systolic Blood Pressure (SBP) before dialysis was 148 mm Hg ?16.62 and the average Diastolic Blood Pressure (DBP) before dialysis was 88 mm Hg ?12.50. Pre-dialysis Blood Pressure—140/90 mm Hg was noted in 18 cases, or 34.0%. The intradialytic average SBP was 164 mm Hg ?17.25 with extremes of 121 to 202 mm Hg. The intradialytic average DBP was 92 mm Hg ?12.52 with extremes 67 to 124 mm Hg. The main risk factors associated with intra-dialytic hyperation were: Age range (40 - 50 years), Duration on dialysis (<6 months). Vascular nephropathy, hypoalbuminemia, Pre-dialytic Blood Pressure ≥ 140/90 mmHg. BP post dialysis ≥ 165, Dry weight ≥ 70 Kg, Number of antihypertensive agents ≥ Ultrafiltration rate ≥ 550 ml/h. Conclusion: This study, the first of its kind in Guinea, was able to determine the frequency of intradialytic hypertension and the factors associated with it.
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Diakité et al. (2020) conducted a cross-sectional in End-Stage Renal Disease on Chronic Hemodialysis (n=131). Risk factors for intradialytic hypertension (e.g., vascular nephropathy, hypoalbuminemia) vs. Patients without the respective risk factors was evaluated on Prevalence of intradialytic hypertension. Intradialytic hypertension occurred in 40.5% of chronic hemodialysis patients and was significantly associated with factors including vascular nephropathy, hypoalbuminemia, and the use of multiple antihypertensive agents.
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