Association between Hyperparathyroidism and Intradialytic Hypertension in Prevalent Hemodialysis Patients

Abstract

Background: Over 80% of patients receiving hemodialysis have hyperparathyroidism, a common complication of chronic kidney disease  (CKD) that is a major concern; given the increased cardiovascular risk and declining quality of life associated with CKD. Early stages of  CKD are when the pathophysiologic mechanisms causing secondary hyperparathyroidism begin, and they intensify in direct proportion to  the loss of renal function.

Objective: Investigate the association between hyperparathyroidism and intradialytic hypertension in  prevalent hemodialysis patients.

Patients and Methods: We conducted a multicenter cross-sectional study at a total of 70 prevalent  hemodialysis patients with hyperparathyroidism (iPTH>300), aged more than 18 years old and less than 60 years at El-Dakahlia Governorate hospitals. They have been recruited to our study design and assigned according to developing intradialytic hypertension  into group 1: patients with intradialytic hypertension (n=10) and group 2: patients without intradialytic hypertension (n=60) and they were  subjected to detailed medical history, examinations, and laboratory investigations.

Results: The patients with intradialytic  hypertension had higher mean of weight gain (1.9 ± 0.9 kg) than patients without (0.9 ± 0.3 kg) with statistically significant differences  between them as p=0.025. We also noted a statistically significant difference between both groups as regards the intradialytic blood  pressure measurements (p<0.05) with a difference between post versus pre dialytic systolic blood pressure monitoring in the patients  within each group (p<0.001). Lower mean of hemoglobin level has been detected in the patients with intradialytic hypertension with statistically significant differences between both groups as p=0.011.

Conclusion: Our study demonstrated that no statistically significant  correlation noted between the prevalence of intradialytic hypertension and hyperparathyroidism among prevalent hemodialysis patients.