eISSN: 2345-2781  
Submitted: 26 Jan 2018

Accepted: 20 Apr 2018
First published online: 10 May 2018
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J Renal Inj Prev. 2018;7(3):152-159.
doi: 10.15171/jrip.2018.38

Original

The main determinants of intradialysis hypertension during dialysis in chronic hemodialysis patients; a single-center study

Mohammadreza Abbasi 1, Bahareh Hajisalimi 2 *

1 Department of Intimal Medicine, Tehran University of Medical Sciences, Tehran, Iran
2 Zanjan Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
*Corresponding author: Bahareh Hajisalimi, Email; Email: baharehajisalimi@yahoo.com

Abstract

Introduction: Raising or lowering blood pressure and muscle cramps are the main barriers for dialysis. Meanwhile, lowering blood pressure is more common and its mechanism is somewhat clear. But the mechanism for increasing blood pressure is not yet clear fully.

Objectives: In this study, we examined the prevalence of intradialytic hypertension (IDH) and its related factors, especially changes in plasma renin activity, hematocrit, heart rate, and electrolytes in end-stage renal disease (ESRD) patients undergoing chronic hemodialysis.

Patients and Methods: In a cross-sectional study, patients with chronic end-stage renal disease under chronic hemodialysis were included to the study in the absence of a specific infection, as well as in lack of intravenous fluid providing during dialysis due to hypotension. Blood pressure and heart rate before and after hemodialysis were measured in four consecutive dialysis sessions. Elevating mean arterial blood pressure by 15 mm Hg between beginning and end of dialysis or raising blood pressure within four consecutive dialysis sessions were considered as IDH.

Results: Around 17 of the 88 (19.3%) patients with hemodialysis had IDH. These subjects were compared with non-IDH patients who were similar in age and gender. The most common underlying disease in both groups was diabetes mellitus followed by hypertension. Comparison of measured parameters before and after dialysis showed that serum potassium level was significantly decreased in both groups. Serum sodium level increased in both groups, but this increase was significant only in the control group. There were no significant changes in renin plasma activity, heart rate and hematocrit levels in both groups.

Conclusion: In this study, plasma renin activity in IDH group increased after dialysis compared to pre-dialysis. This finding requires to more test with larger sample size.

Implication for health policy/practice/research/medical education:

In this study on a group of hemodialysis patients, we found that plasma renin activity in the intradialytic hypertension group increased during dialysis and after dialysis compared to pre-dialysis, while in the control group it decreased after dialysis compared to pre-dialysis.

Please cite this paper as: Abbasi M, Hajisalimi B. The main determinants of intradialysis hypertension during dialysis in chronic hemodialysis patients; a single-center study. J Renal Inj Prev. 2018;7(3):152-159. doi: 10.15171/jrip.2018.38.

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