Sp659intradialytic Hypertension in Indonesian End Stage Renal Disease Patients: Prevalence and Clinical Characteristics

Japar, Karunia Valeriani; Waren, Kalis; Wibisono, Prio; Vatvani, Akhil Deepak; Lam, Pebe; Lemuel, Theo Audi Yanto

doi:10.1093/ndt/gfx154.sp659

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“…Intradialytic hypertension reported in our study was found among 16% of the participants. Our study has reported relatively low estimates of IDH compared to other studies, which have reported an estimated frequency of IDH ranging from 22.3% to 44.5% according to the various definitions used earlier [9][10][11][12].…”

Section: Discussioncontrasting

confidence: 68%

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Frequency of Intradialytic Hypertension Using Kidney Disease: Improving Global Outcomes (KDIGO) Suggested Definition in a Single Hemodialysis Centre in Pakistan

Mujtaba¹,

Qureshi²,

Dhrolia³

et al. 2022

Cureus

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Objectives: To estimate the frequency of intradialytic hypertension (IDH) in our centre as per the definition suggested by Kidney Disease: Improving Global Outcomes (KDIGO).Methods: A cross-sectional study was conducted at the dialysis department of The Kidney Centre Post Graduate Training Institute (PGTI) Karachi, Pakistan from August 2021 to October 2021 among 263 endstage kidney disease (ESKD) patients on maintenance hemodialysis (MHD) aged ≥ 18 years of both genders. The study outcome was the frequency of IDH as per the latest KDIGO suggested definition i.e., systolic blood pressure (SBP) rise of > 10 mm Hg from pre-to post-dialysis within the hypertensive range in at least four out of six consecutive dialysis treatments. Frequencies (%) and mean (±SD) were calculated for categorical and continuous variables respectively, using SPSS version 21 (IBM Corp., Armonk, NY, USA).Results: Among 263 patients, the mean age was 51.02 (±14.1) years and 56.3% were males. Around 30.8% of patients were dialysis-dependent for 1.1 to three years. The most common comorbidity was hypertension (88.6%). Standard dialysate calcium of 3mEq/l was received by 91.6% of study participants. About 78.7% of patients were using antihypertensive(s), out of which 85.5% were compliant and 37.6% were using a single antihypertensive. The most common antihypertensive in use was beta-blockers (78.3%). Around 16% of patients were found to have IDH. Age of the patients was significantly associated with IDH (p=0.038). The majority of the patients with IDH were those who were taking anti-hypertension medications as compared to the patients who were not taking them (p <0.004). Interdialytic weight gain was not a significant predictor for IDH. Conclusion:The frequency of IDH was 16% according to the latest suggested KDIGO definition. This is much lower than regional and global estimates according to earlier definitions. There is a dire need to establish a standardized definition of IDH in guidelines to diagnose, manage and compare data. Also, the association of IDH with fluid overload is not found in our study which emphasizes the need to evaluate other causative factors.

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Section: Discussioncontrasting

confidence: 68%

“…Research conducted in the 1990s shows the frequency of IDH as 5% to 15% [ 8 ]. Recent studies show a frequency of 22.3% in the USA [ 9 ], 40.5% in the West African country Guinea [ 10 ], and 34.1% in Indonesia [ 11 ]. The neighboring country India has a frequency of 34.51% [ 12 ].…”

Section: Introductionmentioning

confidence: 99%