Background:Chronic kidney disease (CKD) is a progressive disorder associated with high morbidity and mortality, frequently progressing to end-stage renal disease (ESRD) requiring dialysis or transplantation. Intradialytic hypertension (IDH), defined as a paradoxical rise in blood pressure during hemodialysis, is an under-recognized complication that adversely affects patient outcomes. Understanding its prevalence and associated factors is critical to improving dialysis care and long-term prognosis. Aim: To determine the prevalence of intradialytic hypertension among patients undergoing maintenance hemodialysis (MHD) and to identify clinical and dialysis-related factors contributing to its occurrence. Methods: A cross-sectional observational study was conducted among insert number patients attending a tertiary renal unit over insert time frame. Data were collected on demographic variables, comorbidities, dialysis-related parameters (including ultrafiltration rate and dialysate sodium), pre- and post-dialysis blood pressure, and medication usage. Statistical analyses were performed to assess associations between IDH episodes and patient- or dialysis-related factors. Results: IDH was found to be prevalent in patients with underlying hypertension, diabetes mellitus, and cardiovascular comorbidities. Late presentation and poor volume control were more common among patients from rural backgrounds. Significant correlations were observed between biochemical markers (serum creatinine, blood urea, and estimated glomerular filtration rate) and CKD severity (p < 0.05). Dialysis-related factors, including ultrafiltration rate and dialysate sodium concentration, were significantly associated with IDH occurrence. Use of multiple antihypertensives was more frequent among IDH patients, with variations in response across different drug classes. Conclusion: Intradialytic hypertension is a common and clinically significant complication of MHD, strongly influenced by pre-dialysis blood pressure, fluid status, and dialysate composition. Early detection through routine monitoring, optimization of dialysis prescriptions, and tailored antihypertensive strategies are essential to reduce IDH burden. Integration of community-based CKD screening and primary care strengthening may further delay disease progression and improve overall patient outcomes.
Wani et al. (Sat,) studied this question.