Hypertension in haemodialysis

ABSTRACT

Relevant factors involved in the pathogenesis of hypertension among dialysis patients include sodium and water retention, dialysate composition and prescription, increased activity of vasoconstrictuve systems [sympathetic nervous system, rennin-angiotensin system, endothelin and vasopressin], decrease activity of vasodilatory systems [nitric oxide, kinins], increased intracellular calcium, increased arterial stiffness, sleep apnea, hyperparathyroidism, erythropoietin and renovascular disease. The objective of this study is to assess the prevalence of hypertension among uremic patients undergoing haemodialysis and to asses difference of blood pressure reading before and after dialysis. 140 patients with chronic renal failure and acute renal failure on regular haemodialysis. Blood pressure was measured by doctors before dialysis, within 2 hhour of dialysis, after dialysis and after 48 hours of dialysis. We averaged six routine predialysis systolic and diastolic blood pressure. The same was carried out for postdialysis. Patients with preheamodialysis [office BP] > 130/85 mmHg are considered as hypertensive in chronic renal failure, who made up of 74% of the study population. 40% patients were on monotherapy antihypertensive drug. 65% are taking calcium channel blocker, angiotensin coverting enzyme inhibitor 38%, angiotensin Pi receptor blockers 26% and beta blocker 20%. Preheamodialysis blood pressure [Office Bp] overestimated Bp values in relation to 48 h postidalysis. Significant difference was shown between predialysis office blood pressure and 48 hour postdialysis in the recognition of hypertension in heamodialysis patients. The prevalence of hypertension in heamodialysis patients is high [74%] most of the patients used combination of antihypertensive drugs, calcium channel blocker commonly used 65%