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Original Paper

Can Predialysis Hypertension Prevent Intradialytic Hypotension in Hemodialysis Patients?

Takeda A.a · Toda T.a · Fujii T.a · Sasaki S.b · Matsui N.a

Author affiliations

aKidney Center, Tsuchiura Kyodo General Hospital, Tsuchiura, and bDepartment of Homeostasis Medicine and Nephrology, Tokyo Medical and Dental University, Tokyo, Japan

Related Articles for ""

Nephron Clin Pract 2006;103:c137–c143

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: June 15, 2005
Accepted: December 20, 2005
Published online: April 24, 2006
Issue release date: July 2006

Number of Print Pages: 1
Number of Figures: 3
Number of Tables: 3


eISSN: 1660-2110 (Online)

For additional information: http://www.karger.com/NEC

Abstract

Background/Aim: Intradialytic hypotension is the most common complication associated with hemodialysis, and its cause is multifactorial. However, the relationship between hypertension and intradialytic hypotension is not clear. We investigated the influence of predialysis blood pressure and antihypertensive drugs on intradialytic hypotension. Methods: Risk factors for intradialytic hypotension were analyzed in 111 patients undergoing regular hemodialysis treatment and had annual echocardiography performed. The correlation between the addition of antihypertensive medications and the incidence of intradialytic hypotensive episodes was studied in 21 hypertensive patients. Results: Based on multivariate logistic regression analysis, diabetes (odds ratio OR 8.18, 95% confidence interval CI 1.47–45.5; p = 0.016), interdialytic weight gain (OR 2.45, 95% CI 1.24–4.82; p = 0.010), ejection fraction (OR 0.88, 95% CI 0.81–0.95; p = 0.001), and left ventricular volume (OR 0.97, 95% CI 0.94–0.99; p = 0.013) were determined as risk factors for intradialytic hypotension. However, there was no association between predialysis blood pressure and intradialytic hypotension. After additional antihypertensive medications, the predialysis blood pressure fell from 175/85 mm Hg to 154/78 mm Hg (p < 0.0001/p < 0.0001). The mean 24-hour interdialytic blood pressure fell from 165/87 mm Hg to 147/80 mm Hg (p < 0.0001/p = 0.006). However, the frequency of hypotensive episodes was not increased (p = 0.77). Conclusions: Diabetes, excessive interdialytic weight gain, low ejection fraction, and low left ventricular volume are independent risk factors for intradialytic hypotension. However, no correlation was found between predialysis blood pressure values or addition of antihypertensive medications and the incidence of intradialytic hypotension. Thus, hypertension may be controlled without aggravating intradialytic hypotension in hemodialysis patients.

© 2006 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: June 15, 2005
Accepted: December 20, 2005
Published online: April 24, 2006
Issue release date: July 2006

Number of Print Pages: 1
Number of Figures: 3
Number of Tables: 3


eISSN: 1660-2110 (Online)

For additional information: http://www.karger.com/NEC


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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