Kerbala Journal of Medicine

Abstract

Aim Of The Study: To Find Out The Incidence Of Intradialytic Hypotension In Esrd.
Patients And Methods: From March To August 2010, (50) Patients With Esrd On Chronic Hemodialysis Program In Al Kindy Teaching Hospital Dialysis Unit Were Studied Cross Sectionally For Evidence Of Idh. The Patients Were On Hemodialysis Program For A Period That Ranged Between 1/4/2004 And 12/4/2010.The Study Sample Consists Of 25 Men And 25 Women With An Age From 18 To 80 Years And Their Body Weight Varied From 40 To 94 Kg And Height Varied From 140 To 186 Cm. Heparin Is Used As An Anticoagulant. Frequency Of Dialysis Differed From One Patient To Another Depending On Patient Condition, Availability Of Machine, It Ranged From Once Weekly To Thrice Weekly Lasting 3-4 Hours Per Session.The Blood Pressure Of All (50) Patients Were Measured Using Mercury Type Sphygmomanometer. The Blood Pressure Were Measured Pre Dialysis During And Post Dialysis. Ultrasound Of Abdomen Done For All (50) Patients. Idh Is Defined As A Decrease In Systolic Blood Pressure By ≥20 Mm Hg Or A Decrease In Map By 10 Associated With Symptoms That Include ; Abdominal Discomfort, Yawning, Sighing, Nausea, Vomiting, Muscle Cramps, Restlessness, Dizziness Or Fainting And Anxiety[2].
Results:For 50 Patients The Following Results Obtained:The Total Number Is 20 Patients Developed Idh(40%).25 Females, Of Them 12 Patients Developed Idh(48%). 25 Males, Of Them 8 Patients Developed Idh(32%), 6 Patient Of Age >_ 65 Years, Of Them 3 Patients Developed Idh(50%).19 Patients Are Overweight (Bmi>25),Of Them 9 Patients Developed Idh(47.4%). 28 Patients With Normal Weight (Bmi=18.5-25),Of Them 10 Patients Developed Idh(35.7%),3 Patients Are Under Weight (Bmi<18.5),Of Them One Patient Developed Idh(33.3%). 41 Patients Take Antihypertensive Treatment, Of Them 16 Patients Developed Idh(39%), 5 Patients Have Diabetes , Of Them 2 Patients Developed Idh(40%).
Discussion: Intradialytic Hypotension Is The Most Common Complication Associated With Hd, And Its Cause Is Multifactorial. Patients Subgroups Most Likely To Have Idh Include Those With Diabetic Ckd And Age >_65 Years. Both Normotensive Or Hypertensive Dialysis Patients Can Develop Idh. The Degree Of Idh In The Same Patient May Vary From Tim To Time, Other Risk Factors For The Development Of Idh Include Female Sex, And The Use Of Nitrates Before A Dialysis Session& Overzealous Use Of Antihypertensive Agents.
Conclusion:Idh Is An Important Complication Of Hemodialysis.ThereIs ASignificant Number Of Patients With Esrd Who Developed Idh.
Keywords:Intradialytic Hypotension, Hemodialysis, Al:Kindy Teaching Hospital