Abstract
Intradialytic hypertension (IDH) is the most common complication of hemodialysis patients in Indonesia. It must be controlled, to maintain the patient's quality of life and prevent worsening conditions. Some factors affecting IDH include predialysis fluid overload characterized by excessive interdialytic weight gain (IDWG), low adherence to fluid restriction and increased ultrafiltration during haemodialysis. The study aims to identify contributing factors of IDH. A case-control design was used in this study. A purposive sampling technique was used to recruit 92 samples at two centres of dialysis in Semarang, which was divided into case group (n=46) and control group (n=46). Data were analyzed using the Chi-square test by calculating Odds Ratios (OR). The finding showed that excessive IDWG (p=0,000, OR=16.95, 95% CI:5,56-51,65), low fluid adherence (p=0,001, OR=4,41, 95% CI:1,82-10,68) and excessive ultrafiltration (p=0,000, OR = 29,52, 95% CI:9,23-94,46) showed significant result. However, the incidence of IDH was not correlated with sex, age and length of haemodialysis. A greater increase in interdialytic weight requires lower fluid and higher ultrafiltration factors must be controlled precisely because those are considered as the risk factors for the high incidence of IDH. Excessive ultrafiltration is the most dominant risk factor in the high incidence of IDH.
Highlights
The prevalence number of Chronic Kidney Disease (CKD) in Indonesia around 90% to 3.8 cases in 1000 population increased significantly past decades, and 19.3% of them require hemodialysis treatment.[1]
The finding showed that excessive interdialytic weight gain (IDWG) (p=0,000, Odds Ratios (OR)=16.95, 95% CI:5,56-51,65), low fluid adherence (p=0,001, OR=4,41, 95% CI:1,82-10,68) and excessive ultrafiltration (p=0,000, OR = 29,52, 95% CI:9,23-94,46) showed significant result
The finding described that Intradialytic hypertension (IDH) incidence were not correlated with sex, age and length of hemodialysis
Summary
The prevalence number of Chronic Kidney Disease (CKD) in Indonesia around 90% to 3.8 cases in 1000 population increased significantly past decades, and 19.3% of them require hemodialysis treatment.[1] CKD patients at the end stage of the kidney disease stage require renal replacement therapy to maintain body functions.[2] Hemodialysis is the main choice of the kidney replacement therapy which is performed routinely to replace part of kidney function in patients with end-stage kidney disease. One of the important complications is the increased of intradialytic blood pressure or the occurrence of intradialytic hypertension (IDH). IDH is a phenomenon where blood pressure increases during the hemodialysis procedure.[5] The blood pressure average decreases in the first hour, and increases more in the third and fourth hours during hemodialysis procedures.[6]
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