Intradialysis blood pressure changes among chronic kidney disease patients on maintenance haemodialysis in a tertiary hospital south - south Nigeria: a 2 year retrospective study

Abstract

Introduction: haemodialysis (HD) which is a form of renal replacement therapy commonly prescribed for patients with chronic kidney disease
(CKD). However, it is not without deleterious haemodynamic responses which may occur either during or immediately after the termination of the
procedure. These may include hypotension or hypertension. Methods: this was a retrospective study that reviewed chronic kidney disease (CKD)
patients on maintenance haemodialysis at the renal unit of University of Calabar Teaching Hospital, Calabar, Nigeria. In all, 71 patients were reviewed
but only 64 patients had complete data for analysis. Socio-demographic, clinical and biochemical data were obtained from the records in the dialysis
unit. Results: there were more males 38 (59.4%) than females 26 (40.6%) in the study. The mean age was 51.71±15.43 years and
43.04±14.03years for males and females respectively. The prevalence of intradialysis hypertension 29 (45.3%) was higher than that of intradialysis
hypotension 20 (31.3%) and the commonest cause of CKD requiring haemodialysis was diabetic nephropathy. The factors associated with intradialysis
hypotension were lower post-dialysis systolic blood pressure (PDSBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and less number
of antihypertensive medications; while the factors associated with intradialysis hypertension were higher post-dialysis systolic blood pressure (SBP),
MAP, greater number of antihypertensive medications and longer duration of haemodialysis. Conclusion: Our study shows that there are several
modifiable factors associated with blood pressure fluctuations among CKD patients on maintenance haemodialysis in the renal unit of the University
of Calabar Teaching Hospital, Calabar.