Abstract: TH-PO224
Intradialytic Hypertension Increases Non-Access-Related Hospitalization and Mortality in Maintenance Hemodialysis Patients
Session Information
- Hemodialysis and Frequent Dialysis - I
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Jeloka, Tarun K., Aditya Birla Memorial Hospital, Pune, India
- Kale, Gajanan Kishor, Aditya Birla Memorial Hospital, Pune, India
- Mali, Manishkumar Shantaram, Aditya Birla Memorial Hospital, Pune, India
- Bhangale, Amit, Aditya Birla Memorial Hospital, Pune, India
- Somani, Jaymin Pradipkumar, Aditya Birla Memorial Hospital, Pune, India
Background
Intradialytic hypertension, in patients on maintenance hemodialysis, is associated with increased morbidity and mortality. This study was aimed to determine the prevalence and outcome of intradialytic hypertension (IDH) in a tertiary care dialysis centre in India.
Methods
This was a prospective analytical study of 120 patients on hemodialysis. At screening phase, all patients were subjected to fluid optimization and adjustment in the antihypertensive medicines for appropriate control of blood pressure (BP). BP measurements during hemodialysis were recorded. The prevalence of IDH was noted. IDH was defined as increase in systolic BP of > 10 mmHg from pre to post hemodialysis or after 2nd hour of dialysis when significant ultrafiltration had occurred, on 3 consecutive sessions. Factors associated with IDH were evaluated and compared with cohort without IDH. The outcome of these patients in terms of morbidity and mortality over a follow up period of 12 months were recorded.
Results
The prevalence of IDH was 21.9%. The baseline demographic parameters of patients in both the groups (with and without IDH) including age, sex, dialysis access, duration of dialysis and comorbidities were similar. Laboratory parameters were similar except serum potassium and serum phosphorus, which were lower in patients with IDH. Out of all the variables studied, only low serum phosphorus was associated independently with IDH. During follow up, at 6 month, 19/71 (26%) non IDH and 12/20 (60%) IDH patients (p = 0.006) and at 12 month, 30/71 (42%) non IDH patients and 12/20 (60%) IDH patients required admission (p = 0.05). Mortality at 6 months was similar, 5/71 (7%) in non IDH and 4/20 (20%) in IDH (p = 0.10) patients, but was higher at 12 months, 11/71 (15.5%) in non-IDH and 8/20 (40%) in IDH (p = 0.028).
Conclusion
Incidence of intradialytic hypertension is high in India (21.9%) with increased morbidity in terms of hospitalization and increased mortality over a period of one year.