12 PREVALENCE AND RISK FACTOR ANALYSIS OF INTRADIALYTIC HYPERTENSION AMONG CHRONIC HEMODIALYSIS PATIENTS IN DR. KANUJOSO DJATIWIBOWO PUBLIC HOSPITAL

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Abstract

Background:

Intradialytic hypertension (IDH) is defined as increased blood pressure (BP) at the end of dialysis compared to pre-dialysis blood pressure (BP). IDH prevalence is variably reported from 5–28.4%. IDH is associated with higher mortality risk in chronic hemodialysis (HD) patients. The mechanism and IDH risk factors remained unclear.

Objective:

To determine the prevalence and risk factor of IDH among chronic HD patients in dr.Kanujoso-Djatiwibowo-Public-Hospital (RSKD)

Method:

Prospective observational study was conducted in September 2016 in RSKD. Patients aged ≥ 18 years-old who have undergone hemodialysis for at least twice per week with minimum period of three months were included. IDH was defined as >10 mmHg increase in post-HD systolic BP in at least three of five consecutive HD-sessions. Blood pressure was measured 30 minutes before and after HD. Demographical and laboratory parameters were evaluated.

Result:

Among 49 subjects, The IDH prevalence was 53.1% (n = 26). The median age was not statistically different between groups (51.0 IQR:13 vs. 53.0 IQR: 20; p:0.302). Male was insignificantly more prevalent in Non-IDH group (69.6% vs 50.0%; p:0.164). We found no significant differences in pre and post-HD body mass index (BMI), comorbid, anti-hypertensive-drugs-usage, hemoglobin, electrolyte, albumin, urea, creatinine, urea reduction ratio, HD duration, ultrafiltration rate, vascular access, intradialytic weight gain, kt/v between two groups. BP and mean atrial pressure after HD were significantly higher in IDH group.

Conclusion:

The prevalence of IDH in RSKD was 53.1%. Age, gender, BMI, comorbid, anti-hypertensive-drug-usage, hemoglobin, electrolyte, albumin, urea, creatinine, HD dose and adequacy were not associated with IDH.

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