Possible Role of Increased Sodium Gradient on Intradialytic Hypertension Phenomenon

Abstract

AbstractBackground: Intradialytic hypertension is poorly under-stood neglected complication of hemodialysis. Better under-standing of the pathogenesis of this phenomenon will lead to better management of this complication.Aim of Work: To detect the frequency of intradialytic hypertension among Hemodialysis patients in Assiut University dialysis unit and the role of increased sodium gradient on this phenomenon.Patients and Methods: A cross-sectional study included 200 hemodialysis patients in Assiut University Dialysis Unit was conducted between January 2017 and Mars 2017. Intra-dialytic hypertension was defined as an increase in systolic BP >10mmHg from pre to post dialysis. Patients were subjected to detailed history and careful examination. Pre and post hemodialysis blood pressure were measured. Pre dialysis plasma sodium was measured and Sodium gradient was calculated as: Dialysate sodium (dNa)-pre hemodialysis plasma sodium (pNa).Statistical Analysis: Statistical analysis of data was per-formed using SPSS version 23. To compare between patients we use student's t-test for unpaired normally distributed data, Mann-Whitney test for medians, and x2 test for categorical data.Results: 60 patients (30%) had intradialytic hypertension. The intradialytic hypertensive patients had lower predialytic plasma Na and higher Na gradient compared to the control group. Mean predialytic Na sodium and Na gradient in the case group were 132.66 and 7.33 respectively, while 137 and 2.7 in the control group respectively.Conclusion: The frequency intradialytic hypertension in our center was 30%. Intradialytic hypertension is strongly associated with increased sodium gradient.