Perdialytic hypertension

Abstract

Research of the hypertialytic hypertension and identification of its risk factors HTA is defined by an increase > 10 mmHg during the dialysis session (10–15% of the dialysis patients). Laryngeal arterial hypertension is one of the many facets of hypertension observed in the uremic tract. HTA is present in 70–80% of chronic renal failure and 50–90% of dialysis patients have BP > 140/90 mmHg. Prospective study of a cohort of 80 hemodialysis patients between 18 and 60 years old, followed between January 2005 and December 2007. We specified the clinical and paraclinical characteristics of these patients. Clinical: Blood pressure, crepitants, edema, presence/absence of hypertialytic hypertension Presence/absence of cramps per or post-hemodialysis. Para-clinical: hemoglobin, cardiothoracic index, ultrasound measurement of inferior vena cava diameter, left ventricular filling pressure (LV), impedance measurement. The mean age is 42.21 10.63 years, with a female predominance and a sex/ratio of 1.16. The averages of PAS and PAD are 145.35 ± 22.15 mmHg and 82.75 10.50 mmHg, that of pulsed pressure is 68.86 ± 15.44 mmHg and that of MAP 102.12 ± 12, 80 mmHg. Diabetic nephropathy accounted for 25% of nephropathies. The ascension of post-dialytic PA compared with pre-dialychic PA was found in 10 of our patients (12.5%) versus 15% in the Inrig series. In a cohort of hemodialysis for 2 weeks, Amerling et al. estimate the frequency of HID, defined by an increase in WFP> 15 mmHg during or just after the hemodialysis session, to 8%. Mees reports that 5–15% of dialysis patients have ultrafiltration-resistant (UF) HTA. The offending factors: Volume overload, found in 7 patients, hypernatric dialysis: 1 case, rapid UF: 2 cases. Previously dialysis was standard, currently it is oriented by efficiency criteria. The ascension of the PA paralyzial is a paradox and several factors are incriminated: water overload, fast UF, short sessions, arterial rigidity, anemia. The use of an ideal dry weight and long hemodialysis allows a Significant improvement in blood pressure control through better control of extracellular volume (ECV). In addition, there is a lack of morbidity and mortality studies among dialysis patients as well as a clear definition of blood pressure targets in this group of patients forgotten by the studies.