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Title: Frequency of intradialytic hypotension in patients with chronic kidney disease.
Authors: Izhar Ali Bangash, Irfan Mirza, Syed Hassan Mustafa, Farah Iqbal
Journal: The Professional Medical Journal (TPMJ)
Publisher: Independent Medical College, Faisalabad- Pakistan
Country: Pakistan
Year: 2023
Volume: 30
Issue: 3
Language: English
DOI: 10.29309/TPMJ/2023.30.03.7110
Keywords: ComplicationsHemodialysisHypotension
Objective: To find the frequency of intradialytic hypotension in chronic kidney disease. Study Design: Cross Sectional Descriptive study. Setting: Hemodialysis Unit of Ayub Teaching Hospital Abbottabad. Period: March 2019 to June 2019. Material & Methods: A total of 95 patients, fulfilling the inclusion criteria were enrolled in the study. After taking consent, relevant history was taken along with physical examination performed. The medical record including various investigations was reviewed. Blood pressure was recorded at regular intervals during the ongoing hemodialysis session of selected patients by the staff of hemodialysis unit, using bedside mercury manometer. Results: Out of 95, 47 patients (49%) developed intradialytic hypotension in the middle of their hemodialysis sessions. There was no significant difference in the frequencies of intradialytic hypotension with respect to gender and age. Conclusion: Hemodialysis is a life saving treatment modality. Despite advances in technology it carries a number of complications. Intradialytic hypotension is one of its frequent complications with a fact that it has no consensus definition. Its frequency in chronic kidney disease patients visiting hemodialysis unit of Ayub Teaching Hospital Abbottabad is high. The high frequency necessitates various interventions for its prevention and further research is required in this regard.
To determine the frequency of intradialytic hypotension (IDH) in patients with chronic kidney disease undergoing hemodialysis.
A cross-sectional descriptive study was conducted in the Hemodialysis Unit of Ayub Teaching Hospital, Abbottabad, from March 2019 to June 2019. A total of 95 patients meeting inclusion criteria (age 18-60, impaired kidney function for 6 months, on regular hemodialysis) were enrolled. Patients with septic shock, cardiogenic shock, massive hemorrhage, severe diarrhea/vomiting, or specific heart conditions were excluded. Blood pressure was recorded at the start and mid-point of hemodialysis sessions using a mercury manometer. Data was analyzed using SPSS version 22, with chi-square tests used for significance at a 5% level. IDH was defined as a drop in systolic blood pressure of 20 mmHg or a drop in mean arterial pressure of >10 mmHg during dialysis.
graph TD
A["Enroll Patients n=95"] --> B["Obtain Consent & History"];
B --> C["Perform Physical Examination"];
C --> D["Review Medical Records"];
D --> E["Record BP at Start & Mid-Dialysis"];
E --> F["Define IDH Criteria"];
F --> G["Identify IDH Cases"];
G --> H["Data Entry & Analysis - SPSS v22"];
H --> I["Stratify by Gender & Age"];
I --> J["Apply Chi-Square Test"];
J --> K["Report Findings"];
The study found a high frequency of IDH in chronic kidney disease patients at the Ayub Teaching Hospital hemodialysis unit, which is concerning due to its association with high mortality. The observed frequency of 49% aligns with some literature but differs from studies using different definitions of IDH. The study found no significant association between IDH and gender or age, which contradicts some previous findings, possibly due to the relatively young mean age of the sample. The authors suggest several preventive measures, including detailed patient history, pre-dialysis investigations, dietary sodium restriction, slow fluid removal, and immediate cessation of dialysis if IDH occurs. Limitations include a small sample size, failure to determine the causes of IDH, and not accounting for common co-morbidities.
Out of 95 patients, 47 (49%) developed intradialytic hypotension during their hemodialysis sessions. The frequency of IDH was not significantly different with respect to gender or age within the study's age range.
A very high percentage of patients undergoing hemodialysis at Ayub Teaching Hospital Abbottabad develop intradialytic hypotension. Given that dialysis is essential for CKD patients, this high frequency is alarming and necessitates immediate action.
1. Sample Size: The study enrolled a total of 95 patients. (Confirmed in "Material & Methods" and "Results").
2. IDH Frequency: 47 out of 95 patients (49%) developed intradialytic hypotension. (Confirmed in "Results").
3. Study Period: The study was conducted from March 2019 to June 2019. (Confirmed in "Abstract" and "Material & Methods").
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