The Association between Intradialytic Hypertension and Metabolic Disorders in End Stage Renal Disease

Raikou, Vaia D; Kyriaki, Despina

doi:10.1155/2018/1681056

Cited by 21 publications

(13 citation statements)

References 42 publications

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“…In our study, the average age of patients was 45.51 years (Table 2). This result is different from those found by other authors; 50.69 -13.89 years [5] and 38.0 -5.9 [13], but much lower than that found in Greece 70.2 -14.3 years [14]. We found a statistically significant link (p-0.044) between age and the occurrence of DHBP.…”

Section: Discussioncontrasting

confidence: 99%

Intradialytic Hypertension and Associated Factors in Chronic Hemodialysis at the National Hemodidiadiasis Center in Donka, Guinea

Diakité¹,

Baldé²,

Koné³

et al. 2020

OJNeph

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Introduction: Dialytic high blood pressure (DHBP), although often ignored, is now recognized as a recurring and persistent phenomenon in a subgroup of hemodialysized patients. Its occurrence is associated with an increased risk of hospitalization and death. The objective of the study was to determine the prevalence of intradialytic hypertension and the factors associated with it. Methods: Study was cross-sectional, monocentric, descriptive and analytical over a three-month period from April 22 to July 22, 2019. Included were all patients 18 years of age or older, chronic hemodialysis for at least three months, with intra-dialytic high blood pressure. The blood pressure machine used for the majority of patients was an electronic "OMRON" blood pressure monitor. Epidemiological, clinical, para clinical and dialysis parameters were studied. The data were collected, captured and analyzed using IBM SPSS Statistics Version 20 software. The factors associated with intradialytic high blood pressure were searched using a univariate logistic regression model. The significance threshold for all statistical tests has been set at 5%. Results: Of our 131 patients, 53 had intradialytic hypertension, a frequency of 40.5%. The time of (DHBP) occurrence was more frequent at the 3rd and 2nd hour, 94.34% and 86.79%, respectively. The average age of patients was 45.51 years with extremes ranging from 19 to 70 years. The average Systolic Blood Pressure (SBP) before dialysis was 148 mm Hg −16.62 and the average Diastolic Blood Pressure (DBP) before dialysis was 88 mm Hg −12.50. Pre-dialysis Blood Pressure-140/90 mm Hg was noted in 18 cases, or 34.0%. The intradialytic average SBP was 164 mm Hg −17.25 with extremes of 121 to 202 mm Hg. The intradialytic average DBP was 92 mm Hg −12.

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Section: Discussioncontrasting

confidence: 99%

Intradialytic Hypertension and Associated Factors in Chronic Hemodialysis at the National Hemodidiadiasis Center in Donka, Guinea

Diakité¹,

Baldé²,

Koné³

et al. 2020

OJNeph

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“…Until further studies determine the pathophysiologic mechanism, we cannot conclude whether the presence of vascular calcification is a risk factor for intradialytic hypotension or if it is an independent condition that occurs in distressed patients with ESRD on hemodialysis. Likewise, some studies have established that patients with intradialytic hypertension had stiff arteries assessed by pulse wave velocity, 29,30 but the relationship of either arterial stiffness or vascular calcification with intradialytic hypertension remains unclear. In summary, this study concludes that calcified vessels may be unconnected to intradialytic BP abnormalities, so further research is essential to clarify the vascular factors that cause a considerable BP drop or rise over the course of dialysis treatment.…”

Section: Figmentioning

confidence: 99%

Impacts of Coronary Artery Calcification on Intradialytic Blood Pressure Patterns in Patients Receiving Maintenance Hemodialysis

et al. 2020

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Intradialytic blood pressure abnormalities are associated with adverse outcomes in patients with end-stage renal disease on dialysis. Vascular calcification is a common complicating feature, but whether this complication results in intradialytic blood pressure abnormalities remains uncertain. Therefore, this study investigated the relationship between coronary artery calcium score and intradialytic blood pressure abnormalities in patients with end-stage renal disease on maintenance hemodialysis. Thirty-six patients who received nongated chest computed tomography scans were included. Intradialytic hypotension was defined as a minimum intradialytic systolic blood pressure of <100 mmHg or a pre-dialysis blood pressureminimum intradialytic systolic blood pressure >30 mmHg. Intradialytic hypertension was defined as >10 mmHg increase in systolic blood pressure (pre-to post-dialysis). Patients were classified as 22 (61.1%) with coronary artery calcium score <400 and 14 (38.9%) with coronary artery calcium score ≥400. Median systolic and diastolic blood pressures were equivalent, but median pulse pressure was higher in patients with coronary artery calcium score ≥400 than in those with scores <400. Coronary artery calcium score was comparable according to both intradialytic hypotension and hypertension, and had no correlation with systolic blood pressure fall and nadir systolic blood pressure. Coronary artery calcium score predicted the occurrence of cardiovascular events and all-cause mortality (hazard ratio 1.001 and 1.001; p=0.058 and 0.010). Coronary vascular calcification could be irrelevant to intradialytic blood pressure abnormalities in patients with end-stage renal disease on dialysis.

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“…In a subsequent cross-sectional study, patients with IDH exhibited higher carotid-femoral PWV and augmentation index (AIx) compared with patients without IDH. 17 Finally, in a previous study of our group, we demonstrated that patients with IDH had significantly higher pre-dialysis PWV and AIx(75), together with a negligible reduction in AIx(75) during dialysis compared with individuals without IDH. 18 As patients with IDH display a different brachial BP trajectory during the intra-and interdialytic period and a higher cardiovascular risk than those without the phenomenon, and since ambulatory PWV in haemodialysis displays much stronger associations with mortality than office PWV, we designed a study to examine ambulatory central BP and arterial stiffness parameters and trajectories in patients with and without IDH during a standard 48-h period covering the dialysis session and the interdialytic interval.…”

Section: Introductionmentioning

confidence: 49%

Ambulatory central BP and arterial stiffness in patients with and without intradialytic hypertension

Theodorakopoulou

Karagiannidis

Alexandrou

et al. 2022

Eur J Clin Investigation

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Background Increased arterial stiffness is suggested to be involved in the pathogenesis of intradialytic‐hypertension (IDH). Ambulatory pulse‐wave‐velocity (PWV) is an independent predictor for all‐cause‐mortality in haemodialysis and its prognostic power is better than office PWV. This is the first study examining ambulatory central blood pressure (BP) and arterial stiffness parameters in patients with and without IDH. Methods This study examined 45 patients with IDH (SBP rise ≥10 mmHg from pre‐ to post‐dialysis and post‐dialysis SBP ≥150 mmHg) in comparison with 197 patients without IDH. All participants underwent 48‐h ABPM with Mobil‐O‐Graph‐NG; parameters of central haemodynamics, wave reflection and PWV were estimated. Results Age, dialysis vintage and interdialytic weight gain did not differ between‐groups. IDH patients had higher 48‐h cSBP (131.7 ± 16.2 vs. 119.2 ± 15.2 mmHg, p < 0.001), 48‐h cDBP (86.7 ± 12.7 vs. 79.6 ± 11.5 mmHg, p < 0.001) and 48‐h cPP (45.5 ± 10.4 vs. 39.8 ± 10.0 mmHg, p = 0.001) compared to patients without IDH. Similarly, during day‐ and nighttime periods, cSBP/cDBP and cPP levels were higher in IDH‐patients compared to non‐IDH. Forty‐eight‐hour augmentation pressure and index, but not AIx(75) were higher in IDH patients; 48‐h PWV (10.0 ± 2.0 vs. 9.2 ± 2.1 m/s, p = 0.017) was significantly higher in patients with IDH. The two study groups displayed different trajectories in central BP and PWV over the course of the recording; IDH patients had steadily high values of the above variables during the 2 days of the interdialytic‐interval, whereas non‐IDH patients showed a gradual elevation, with significant increases from the 1st to 2nd 24 h. Conclusions IDH patients have significantly higher levels of ambulatory central BP and arterial stiffness parameters and a different course over the 48‐h period compared with non‐IDH patients. Increased arterial stiffness could be a prominent factor associated with the high burden of cardiovascular disease in this population.

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The Association between Intradialytic Hypertension and Metabolic Disorders in End Stage Renal Disease

Cited by 21 publications

References 42 publications

Intradialytic Hypertension and Associated Factors in Chronic Hemodialysis at the National Hemodidiadiasis Center in Donka, Guinea

Intradialytic Hypertension and Associated Factors in Chronic Hemodialysis at the National Hemodidiadiasis Center in Donka, Guinea

Impacts of Coronary Artery Calcification on Intradialytic Blood Pressure Patterns in Patients Receiving Maintenance Hemodialysis

Ambulatory central BP and arterial stiffness in patients with and without intradialytic hypertension

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