A17266 Intradialytic Hypertension and Its Association with Nitric Oxide Level Changes

Abstract

Objectives: Intradialytic hypertension is associated with increased morbidity and mortality, yet the mechanism is uncertain. Prior studies investigate imbalances in endothelial-derived vasoregulators nitric oxide, which these studies show conflicting result. The aim of the study was to investigate the association between intradialytic hypertension and the changes of nitric oxide level pre-to-post-dialysis. Methods: We conducted a before-and-after experimental studies in hemodialysis unit of Mohammad Hoesin General Hospital Palembang including 12 hemodialysis subjects without (controls) and 12 with intradialytic hypertension (an increased systolic BP pre-to-post-dialysis ≥10 mmHg in ≥4/6 consecutive HD sessions). The primary outcome was the changes of nitric oxide pre-to-post-dialysis, which was assessed in the 7th HD session, using ELISA. Dependent t-test was used to compare nitric oxide level changes. Results: Baseline characteristics, comorbidities, and anti-hypertensive drug consumption were similar between groups. Compared with controls, nitric oxide level changes was significantly higher among subjects with intradialytic hypertension (14.21 ± 10.24 u/M vs 6.45 ± 5.00 u/M). The changes of nitric oxide level pre-to-post-dialysis between 2 groups showed mean difference of 9.14 ± 2.06 u/M and 95%CI value was 4.87–13.41. Conclusion: Intradialytic hypertension is associated with nitric oxide level changes. We propose that nitric oxide level changes pre-to-post-dialysis may partially explain the higher event rates observed in these patients.