Impact of Hemodialysis Time Prolongation on Blood Pressure Control

Abstract

Cardiovascular mortality represents the leading cause of death in ESRD maintained on regular HD. HTN highly prevalent among maintenance HD patients and increasing annually; however, it still represents complex issue in hemodialysis practice and only a minority has adequate control due to multifactorial pathogenesis in addition to absence of strict definition & tool for hypertension diagnosis in those patients. Volume overload and sodium retention are the major pathogenic mechanism of HTN in ESRD as the excretory function is severely impaired even with some preserved residual renal function. HD is a potent tool to remove excess sodium and water, thus, strategies that involve longer HD sessions & strict dietary sodium control are associated with better BP control and reduction in HTN prevalence. The duration of dialysis session and UFR are associated with the incidence of IDH that interferes with HD adequacy through decreased HD tolerability. The longer dialysis sessions allow for slower UFR and tolerance of greater fluid removal, leading to improved control of hypertension. The current work is observational study, 50 adult, prevalent, hypertensive HD patients recruited from Manshyia El Bakry General Hospital were included. Patients were divided into two groups according to HD session duration: Group A included 25patients who received 4.5 hour HD session duration, and group B included 25 patients who received the usual 4 hours HD session duration.