[PS 03-17] HYPERTENSION: HOW DOES IT BEHAVE IN A HAEMODIALYSIS UNIT?

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Abstract

Objective:

Hypertension is a common complication in chronic kidney disease (CKD) patients undergoing haemodialysis (HD) treatment and is a risk factor for cardiovascular complications and morbi-mortality increase. The study presented here aims to establish the prevalence of hypertension in a population of HD patients and evaluate characteristics and risk factors that provoke its incidence.

Design and method:

The investigation was a transversal study. Hypertension was defined with systolic blood pressure (BP) ≥140mmHg and/or diastolic BP ≥90mmHg (European Hypertension Guidelines 2013). The BP was registered before and after the HD session.

Results:

Of 109 patients included were 60.6% men. The mean age was 61.7 ± 13.78 years. The mean time in HD was 46.58 months. 89% of the patients suffered from hypertension. Hypertension before HD session was presented in 31.2%, and a 22.9% of them presented it after their HD session. Pre-dialysis mean systolic and diastolic BP readings were 131.8 ± 25.85 and 72.9 ± 12.56 mmHg respectively; and post-dialysis were 124.2 ± 24.65 and 68.8 ± 12.68 mmHg, respectively. Concomitant pathologies present in the population under study were 57.8% dyslipidemia, 29.4% with left ventricle hypertrophy, 27.5% diabetics, 27.5% smokers, 26.6% obese and 20.2% with ischemic heart disease. The breakdown of the most commonly administered drugs is as follows: beta-blockers 40.4%, ARB 29.4%, calcium antagonists 28.4%, furosemide 46.8%, alpha-blockers 21.3%, ACEI 2.8% and minoxidil 2.8%. From the 31.2% of patients that presented hypertension before the HD session, 63.6% of them were men. In hypertension before the HD session, the comparative analysis saw statistical significance in the diabetic group (50% vs 24.1%).

Conclusions:

1) Hypertension is highly prevalent in patients undergoing HD, although the percentage of patients with major hypotension readings during the HD session is remarkable. The percentage of patients with a maintained hypotension is also important. 2) Most patients need a combined drug therapy to control the BP. 3) Diabetic patients under HD procedure frequently present hypertension.

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