Intra-dialytic Hypotension in Hemodialysis Patients: A Single Center Evaluation

Introduction: Intra-dialysis hypotension (IDH) occurs in 20- 55% of hemodialysis sessions and is more frequent among patients on long-term hemodialysis. We aimed to define the impacts of blood pressure status, inter-dialysis weight gain, vasodilators antihypertensive drugs, characteristics of hemodialysis, serum calcium, sodium, and albumin and hemoglobin concentrations on prevalence of intra-dialysis hypotension.Methods: 44 hemodialysis cases in 508 dialysis sessions were evaluated for intra-dialysis hypotension. They included 19 girls and 25 boys aged 4.8- 25 years. A decrease in mean BP≥ 10 mm Hg during hemodialysis was defined as hypotension.Results: IDH was noted in 136 of 508(26%) dialysis sessions. It was significantly more prevalent in cases with normal systolic and diastolic blood pressures compared with those who had diastolic or systolic hypertension (P=0.014 and P=0.005 respectively).There were no meaningful differences in prevalence of hypotension based on characteristics and duration from onset of dialysis, and inter-dialysis weight gain (P> 0.05 for all).Also it was as common in cases treating with vasodilators drugs as those without (P=0.221). Serum calcium, sodium and hemoglobin levels didn’t have significant differences between cases with and without IDH, whereas those with IDH had a significantly lower serum albumin concentration (P=0.021).Conclusion: normotensive patients and cases with lower serum albumin concentrationsare more prone to develop IDH. Measurement of blood pressure with shorter intervals in normotensive patients is recommended for early diagnosis of IDH

Keywords:

Hemodialysis , blood pressure , IDH , dialysis sessions , serum albumin concentrating