Prevalence and risk factors of intra-dialytic hypotension: A 5 year retrospective report from a single Nigerian Centre

Abstract

Introduction: Intra-dialytic hypotension (IDH) is a common complication of  haemodialysis that impacts negatively on the patient's quality of life and can induce serious cardiovascular events.

Methods: Records of all adults who had haemodialysis treatments from Jan 2012-Jan 2016 were reviewed. Socio-demographic data, health status of patient, aetiology of renal disease, clinical and biochemical parameters such as systolic and
diastolic blood pressures (SBP and DBP), packed cell volume, were collated using Microsoft Excel.

Results: The overall prevalence of intra-dialytic hypotension was 8.6%. Of all haemodialysis patients, 45.7% experienced a drop in SBP > 20mmHg, 28.5% required nurses' intervention and 8.6% had symptoms. Diagnosis of obstructive nephropathy (OR: 3.1, CI:1.43-6.60, p = < 0.004) and sepsis (OR: 3.57, CI: 1.31- 9.75, P = 0.013) increased the odds of experiencing IDH. Only 5% of patients with predialysis SBP < 100mmHg developed IDH (OR: 0.12, CI: 0.02-0.93, P = 0.04).

Conclusion: IDH was common among the patients studied. It was more prevalent among patients with obstructive nephropathy and sepsis; however other traditional risk factors of IDH such as older age and anaemia, were not found to be significantly associated with IDH. Surprisingly, prevalence of IDH was significantly less among patients with pre-dialysis hypotension compared to those without.