Diet and dialysis to control hypertension in patients on dialysis

Abstract

Introduction: Uncontrolled hypertension in hemodialysis (HD) patients is related to a variety of causes, of which dietary salt intake plays a major role. Excessive interdialytic weight gain (IDWG) with accompanying hypertension can lead to increase cardiovascular morbidity and mortality. Materials and Methods: We conducted a cross-sectional observational study to assess the prevalence of hypertension among patients on maintenance HD (MHD) and its relationship with daily sodium intake. We included participants who were getting MHD at out tertiary care center and in whom a digital brachial blood pressure (BP) was measured. Results: Of the 118 patients studied, 73 (61.9%) were male. AVF was the access for HD in 88 (74.6%) patients, 22 (18.6%) patients were getting HD through a permcath, and the rest through a temporary central venous HD catheter. HD was being done once a week for 3 (2.5%) patients, 80 (67.8%) patients were getting HD twice a week, and the others thrice a week. The mean pre-HD BP was 151.7/80 ± 22.55/12.8 mmHg, and the mean post-HD BP was 168/90.9 ± 23.7/11.3 mmHg. An IDWG of 2 kg. The mean IDWG was 2.41 kg. Seventeen (14.4%) patients were not on any antihypertensive medications, 48 (40.7%) patients were taking 1–2 antihypertensive drugs, and the rest were on >3 antihypertensive drugs. A urine output of