Prevalence of Intradialysis Hypertension and the Associated Risk Factors in Patients with Hypertension and ESRD Undergoing Maintenance Hemodialysis in Three Hemodialysis Centers at Addis Ababa : A Retrospective Cross Sectional Study
| dc.contributor.advisor | Melkie Addisu | |
| dc.contributor.author | Bedru Zekariya | |
| dc.date.accessioned | 2025-08-12T19:49:14Z | |
| dc.date.available | 2025-08-12T19:49:14Z | |
| dc.date.issued | 2024 | |
| dc.description.abstract | Background: Intradialytic hypotension is an established, common, and risky complication of hemodialysis.(1) However, hypotension is only 1 component of theabnormal hemodynamic response to ultra filtration dialysis; the oppositephenomenon, that is, paradoxical rise in blood pressure (BP) during or immediatelyafter dialysis, intradialytic hypertension is equally common and associates withadverse cardiovascular outcomes. (1, 2) IDH affects 5-15% of patients. (1) Thepathophysiologic of IDH is complex and not fully understood, but several factorsare thought to play a role, including volume overload, RAAS activation,endothelial dysfunction, and sympathetic over activity. (1) Objective: the aim of the study is to assess prevalence of Intradialysis hypertension (IDH) and the associated factors with it in three private HD centers Secondary objective: to assess the prevalence of Intradialysis hypotension DESIGN: Retrospective cross sectional study Methodology: study population was all ESRD patients on maintenancehemodialysis aged 18 and above who meet inclusion criteria and were willing to participate in the study. Blood pressure was recorded for all patients at pre- dialysis, 1st, 2nd, 3rd and post dialysis time for the last consecutive 6 sessions.Blood pressure records are by the HD machine and if unexpectedly high it will beconfirmed by manual BP device (sphygmomanometer). Demographic and otherclinical data were collected from patient charts and by interviewing patients. Data analysis was done by SPSS26. The factors associated with IDH will be researchedusing a univariate logistic regression model. The significance threshold for allstatistical tests has been set at 5%. A P value of less than 0.05 is consideredsignificant. Result: our study included 156 patients and analyzed 936 HD sessions overthree week’s period. Close to half of the patients (49.4%) are between 40-60 yearsof age. Males accounted for 65.4%, females 34.6%. Diabetes mellitus was presentin 28.2% (44) of the patients. Majority of the participants were on MHD for more than a year (1-2 years (30.8%), >/= 2 years (34.6%). 69.9% (109) of the participants underwent twice per week of MHD while 27.6% (43) underwent thriceper week of MHD. A single session of HD lasts for 3.5hrs in 75% of the cases andthe rest for 4hrs. Mean ultra-filtration rate of >/= 13ml/kg/hr was prevalent in42.3%. The mean pre HD SBP of 140-160mmhg accounted for 41% and SBP>180in 7.7%. 42.9 %( 67) of the participants were on dual antihypertensive.Prevalence of IDH was 27.6 %( 43) and intradialytic hypotension was found in 648sessions out of 936 sessions of HD (69.2%). The single factor affecting IDH was ultra filtration rate. Conclusion: our study showed that IDH is very prevalent in our set up and itis more common in those with lower ultra filtration rate. The prevalence of higher ultra filtration rate is very high close to half of patients had rate of >/= 13ml/kg/hr. | |
| dc.identifier.uri | https://etd.aau.edu.et/handle/123456789/6460 | |
| dc.language.iso | en_US | |
| dc.publisher | Addis Ababa University | |
| dc.subject | Intradialytic Hypertension End Stage Renal Disease Maintenance Hemodialysis | |
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| dc.title | Prevalence of Intradialysis Hypertension and the Associated Risk Factors in Patients with Hypertension and ESRD Undergoing Maintenance Hemodialysis in Three Hemodialysis Centers at Addis Ababa : A Retrospective Cross Sectional Study | |
| dc.type | Thesis |