Pre-dialytic Systolic Blood Pressure is an Independent Predictor of Intradialytic Hypertension

Abstract

BACKGROUND: Since endothelial dysfunction and activation of renin-angiotensin aldosterone system are the primary mechanism of intradialytic hypertension (IDHT), the assessment of pre dialytic blood pressure might provide an important information for the prediction of IDHT. OBJECTIVES: To assess the association between pre dialytic blood pressure and the risk of IDHT. METHODS: We conducted a cross-sectional study in Universitas Muhammadiyah Malang Hospital. The inclusion criteria were all hemodialysis patients aged more than 18 years, and the exclusion criteria were patients with hemodialysis duration of less than three months, patients with poor compliance to consume antihypertensive drugs, and hemodynamically unstable. The predictor variable was pre dialytic systolic blood pressure and the outcome was the incidence of IDHT. The association between pre dialytic blood pressure and the risk of IDHT was assessed using multiple logistic regression. RESULTS: A total of 36 patients with IDHT and 60 patients without IDHT was enrolled in our study. Our study identified that pre dialytic systolic blood pressure was associated with the risk of IDHT, with mean difference was 10.90 mmHg between patients with IDHT and without IDHT. Our study confirmed that the levels of pre dialytic systolic blood pressure 135 mmHg was the optimal cut off, and we found that patients with pre dialytic systolic blood pressure ≥ 135 mmHg had 4.60-fold to develop IDHT compared to patients with pre dialytic systolic blood pressure < 135 mmHg. CONCLUSION: Our study reveals that pre dialytic systolic blood pressure is an important predictor of IDHT.