Incidence of intradialytic hypertension in hemodialysis patients in Beheira governorate and effect of high flux versus low flux dialysis on it

Abstract

I ntradialytic hypertension (IDH) is a common complication of HD that is under-recognized and its significance is underappreciated. No standard definition of IDH exists. As a unifying criteria for the diagnosis of IDH has not been proposed, the focus of this review will be on SBP rise ≥ 10 mmHg at ≥ 4 over six consecutive sessions. IDH is estimated at 5–15% of HD patients. IDH has been associated with poor clinical outcomes in HD patients including increased hospitalizations, higher ambulatory BP, cardiovascular morbidity, and mortality. Numerous factors have been suggested to contribute to the development of IDH. Management of IDH patients should include an initial reassessment of dry weight. Patients with persistent IDH should be managed with less dialyzable drugs, and there is some evidence that carvedilol may provide a specific benefit. Modification of the dialysate sodium can be considered, although labs and hemodynamics should be carefully monitored. The principle of HD involves the clearance of solutes across a semi-permeable membrane through diffusion and ultrafiltration mechanisms. The dialyzer is where the blood and dialysis solution circuits meet, and where the movement of molecules between dialysis solution and blood across a semipermeable membrane occurs. According to its ability to remove solutes from the blood, a dialyzer can be classified into low flux or high flux.