Intradialytic hypertension (IDH) is defined as increased blood pressure (BP) at the end of dialysis compared to pre-dialysis blood pressure (BP). IDH prevalence is variably reported from 5–28.4%. IDH is associated with higher mortality risk in chronic hemodialysis (HD) patients. The mechanism and IDH risk factors remained unclear.
To determine the prevalence and risk factor of IDH among chronic HD patients in dr.Kanujoso-Djatiwibowo-Public-Hospital (RSKD)
Prospective observational study was conducted in September 2016 in RSKD. Patients aged ≥ 18 years-old who have undergone hemodialysis for at least twice per week with minimum period of three months were included. IDH was defined as >10 mmHg increase in post-HD systolic BP in at least three of five consecutive HD-sessions. Blood pressure was measured 30 minutes before and after HD. Demographical and laboratory parameters were evaluated.
Among 49 subjects, The IDH prevalence was 53.1% (n = 26). The median age was not statistically different between groups (51.0 IQR:13 vs. 53.0 IQR: 20; p:0.302). Male was insignificantly more prevalent in Non-IDH group (69.6% vs 50.0%; p:0.164). We found no significant differences in pre and post-HD body mass index (BMI), comorbid, anti-hypertensive-drugs-usage, hemoglobin, electrolyte, albumin, urea, creatinine, urea reduction ratio, HD duration, ultrafiltration rate, vascular access, intradialytic weight gain, kt/v between two groups. BP and mean atrial pressure after HD were significantly higher in IDH group.
The prevalence of IDH in RSKD was 53.1%. Age, gender, BMI, comorbid, anti-hypertensive-drug-usage, hemoglobin, electrolyte, albumin, urea, creatinine, HD dose and adequacy were not associated with IDH.
1dr. Kanujoso Djatiwibowo Public Hospital, Balikpapan, East Kalimantan
2Department of Internal Medicine, dr. Kanujoso Djatiwibowo Public Hospital, Balikpapan, East Kalimantan
3Department of Clinical Nutrition, dr. Kanujoso Djatiwibowo Public Hospital, Balikpapan, East Kalimantan
4Department of Clinical Pathology, dr. Kanujoso Djatiwibowo Public Hospital, Balikpapan, East Kalimantan
5Department of Internal Medicine, Faculty of Medicine Universitas Indonesia-Cipto Mangunkusumo Hospital, Jakarta, Indonesia
6Division of Nephrology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia-Cipto Mangunkusumo Hospital, Jakarta, Indonesia