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Page 41
Volume 2
Journal of Clinical Diagnosis and Treatment
Annual Nephrology & Chronic Diseases 2019
May 20-21, 2019
Nephrology
Chronic Diseases
May 20-21, 2019 London, UK
19
th
Annual Conference on
3
rd
International Conference on
&
Study of intradialytic hypertension at a tertiary care hospital
Vajed Mogal
Dr. D. Y. Patil Medical College, Hospital & Research Centre, India
Introduction:
Hypertension is perhaps one of the most common problems of patients with end stage
renal disease (ESRD). Hypertension is highly prevalent ESRD in patients on maintenance hemodialysis
(HD). Intradialytic hypertension (IDH) is one such complication responsible for increased morbidity
and mortality in chronic kidney disease (CKD) patients undergoing hemodialysis. In India, there
is limited data available in the literature for the incidence of IDH in CKD patients on hemodialysis.
Aims & objective:
To study the prevalence of Intradialytic Hypertension in patient undergoing regular
hemodialysis and factors responsible for Intradialytic Hypertension.
Methods:
The study was a randomized prospective single center study. It included all the patients of
chronic kidney disease (CKD)undergoing maintenance hemodialysis 2 or 3 times a week. Patients of
Acute Kidney Injury will be excluded from study. Serial Blood pressure (BP) recordings were taken
on monitor at the beginning of hemodialysis session, at the end of hemodialysis session and at 1 hour
during the session; for 2 hemodialysis sessions. Patient was defined as having Intradialytic Hypertension
(IDH) if there was;> 10mm Hg systolic BP rise on HD session, in more than 2 HD. The data obtained
was studied based on 13 parameters and chi square test was applied to the attributes to test their
significance at 1 degree of freedom and at5% level of significance. (p value <0.005 statistically significant).
Results :
During this study it was found that mean age of all subjects was 42.26 ± 14.69 years. 95(95%) had
history of hypertension, 28(28%) had history of diabetes mellitus, and 12(12%) had history of ischemic
heart disease. 31(31%) patients were found to have intradialytic hypertension (IDH). 96(96%) subjects
were on calcium channel blockers, 70 (70%) were on beta blockers, and 44 (44%) were on alpha blockers,
and 10 (10%) on central sympatholytic. Regression analysis was performed to find out independent risk
factors for IDH. It was found that Pre-HD SBP was an independent risk factor for IDH after adjusting for
gender, diabetes mellitus, HD vintage, cholesterol, IDWG, frequency of HD and types of anti-hypertensive
drugs (CCB, α blocker, β blocker, CS). Interdialytic weight gain and cholesterol are modifiable risk factors
with appropriate measures, so these observations can potentially guide us to prevent in dialysis patients.
CONCLUSION:
Interdialytic weight gain and cholesterol are modifiable risk factors. Pre-HD SBP was
independent risk factor for IDH. Patients with overall higher BP burden likely to develop intradialytic
hypertension (IDH).
drvajedmogal@gmail.comJ Clinical Diagnosis and Treatment, Volume 2