Blood Pressure Changes among Patients Undergoing Hemodialysis in Yenagoa, Nigeria.

Abstract

Introduction: Hemodialysis (HD) is a common modality of renal replacement therapy in Nigeria. Despite its usefulness, it may have complications such as intra-dialytic hypotension (IDH) and intra-dialytic hypertension (IDHTN), both of which may impact negatively on the patient. The aim of the study was to examine blood pressure (BP) changes during HD, to determine the frequency of IDH and IDHTN in patients undergoing HD, and to possibly identify associated factors.

Materials and methods: The study design was a retrospective review of records of patients who had HD in the Rainbow Dialysis Center, a foremost private dialysis center in Bayelsa State. The records of all adults who had HD in the center from June 2014 to June 2018 were reviewed. Data retrieved include sociodemographics, type and cause of renal disease, and clinical and laboratory parameters such as BPs, packed cell volume, urea, and creatinine.

Statistical analysis used: Data were analyzed with SPSS version 20.0. Data were presented in tabular forms. Variables were expressed as mean with standard deviation, frequencies, and percentages. The means were compared using Student's t-test or analysis of variance where appropriate. Chi-square test was used to compare proportions. Statistical significance was set at P < 0.05.

Results: One hundred and thirty-six cases were recruited for the study. IDH and IDHTN were found in 16.9% and 16.2% of the patients, respectively. There was no significant difference between the mean predialysis and postdialysis systolic, diastolic, mean arterial BP, or pulse pressure (P > 0.05). Older age was positively and significantly associated with IDHTN (P = 0.047).

Conclusions: IDH and IDHTN were prevalent among the patients studied, with the latter being slightly more likely to occur with advancing age. There is a need for adequate BP monitoring and management during HD.