The Prevelance and Related Risk Factors of Intradialytic Hypertension in Hemodialysis Patients

OBJECTIVE: We aimed to evaluate the prevalence and clinical correlations of intradialytic hypertension (IDHT) in chronic hemodialysis (HD) patients.

MATERIAL and METHODS: Seventy-six patients who had been receiving hemodialysis in our unit for at least 3 months were included. Demographics and laboratory data were recorded for all patients. Systolic and diastolic blood pressure levels, and UF rate were calculated as the mean values of the last 12 hemodialysis sessions. In addition, 24 hour ambulatory blood pressure monitoring and aortofemoral pulse wave velocity measurements were recorded. An increase of ≥ 10 mmHg in blood pressure reaching 130/80 mmHg and over during more than half of the HD sessions was defined as IDHT.

RESULTS: Systolic IDHT (sIDHT) was detected in 10 of 76 patients (13.2%); either systolic or diastolic IDHT (dIDHT) was detected in 17 of 76 patients (22.4%). There was a positive correlation between IDHT and age, existence of HT, number of antihypertensive drugs, pulse pressure, and aortafemoral pulse wave velocity and a negative correlation with time of HD treatment, rate of UF, serum albumin and Kt/V urea negatively. The independent predictors were age and UF rate for sIDHT and albumin and HT for dIDHT.

CONCLUSION: IDHT is a relatively common complication in HD patients and is correlated with poor prognostic factors. Clinicians should be aware of this insidious complication.