Abstract
Intradialytic hypertension (iHTN) has been related with an increased risk of mortality, with imbalances in trace elements being frequent in maintenance hemodialysis (MHD) patients. The aim of this study was to analyze the relationships between the levels of blood trace elements and iHTN in MHD patients. A total of 144 MHD patients were enrolled in September, 2019 (66 females; 5616 hemodialysis treatments), with a mean age of 64.33 ± 13.39 years and median vintage of 33.50 (16.25–57.50) months. Patients exhibited an average peridialytic systolic blood pressure (SBP) change of − 4.18 ± 20.22 mm Hg in the next 3 months. Thirty-four (23.6%) patients had persistent iHTN (piHTN). These patients were characterized by older age, higher rate of hypozincemia, and modified Charlson comorbidity score, whereas lower blood zinc and hemoglobin, at the time of their recruitment. No significant difference in the levels of other blood trace elements was observed between groups. A general linear mixed (GLM) model showed that with every mg/L point lower mean blood zinc at baseline, the peridialytic SBP change was increased by 4.524 mm Hg (P < 0.001). Binary logistic model in modulate of the GLM model revealed that the lower level of blood zinc was associated with piHTN (OR = 0.433, 95 % CI 0.295 to 0.637, P < 0.001). Multivariate analysis confirmed both above results. Our study indicated that lower blood zinc was independently associated with piHTN in patients undergoing MHD, but prospective studies with larger population are still needed.
Highlights
Hemodialysis (HD) is known to promote a reduction in the levels of blood pressure (BP) in most hypertensive patients, because of the removal of fluids and salt [1], a minority of patients have been shown to regularly exhibit a paradoxical increase either toward or at the end of HD [2]
The imbalance of trace elements has been reported to be very common in HD patients [17], and intradialytic hypertension (iHTN) belongs to the cardiovascular disease (CVD) category associated with the vascular function, rarely studies have focused on the associations between blood or serum trace elements and iHTN
After adjusting for confounding factors, our research showed for the first time an inverse association between the level of blood zinc and peridialytic systolic blood pressure (SBP) change, with lower blood zinc or hypozincemia being independently associated with persistent iHTN (piHTN) in maintenance hemodialysis (MHD) patients
Summary
Hemodialysis (HD) is known to promote a reduction in the levels of blood pressure (BP) in most hypertensive patients, because of the removal of fluids and salt [1], a minority of patients have been shown to regularly exhibit a paradoxical increase either toward or at the end of HD [2]. This phenomenon has been termed intradialytic hypertension (iHTN). Imbalances in trace elements have been associated with the development of cardiovascular disease (CVD), including hypertension [11]. Our study aimed to test the hypothesis that the blood levels of certain trace elements at baseline might be associated with iHTN in HD patients
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