Intradialytic hypotension in dialysis Population

Abstract

Background & Method: This Study was conducted at Department of General Medicine, NSCB Medical College and Hospital, Jabalpur (MP) on patients coming for dialysis with chronic renal failure from all over mahakaushal area of central India with aim of Intradialytic hypotension in dialysis Population. Result: A gradual fall in mean Blood pressure was observed over intradialytic period up to last Post hemodialytic reading. This gradual fall became significantly lower than first mean systolic blood pressure in 90 minute reading and readings after it for Hypertensive group. In Normotensive group fall in mean systolic blood pressure was also significant at 90 minute reading onwards compared to Predialytic measurements. While in Hypotensive patients fall in mean systolic blood pressure showed an early significant fall 60 minute reading onwards compared to predialytic measurements. Fall in mean diastolic blood pressure among Hypertensive group was minute and never significant than predialytic measurement. Similar to hypertensive group mean diastolic blood pressure among Normotensive blood pressure variability group also showed a slight fall but never significant than predialytic measurement. Contrary to the hypertensive and normotensive group the fall in mean diastolic blood pressure was significant at 60 minute reading onwards in Hypotensive study group similar to mean systolic pattern. Conclusion: 116 patients we observed major intradialytic BP variation 45.69% patients were Hypertensive (n=53), 37.93% were Normotensive (n=44) and 16.38% were in Hypotensive groups (n=19). As far as morbidity in these intradialytic blood pressure variability groups is concern; Electrocardiographic abnormalities were significantly higher and highest among three groups while hypertensive group showed significantly higher morbidity in ECG compared to normotensive group. Among individual ECG abnormalities Rhythm and sinus abnormalities, Left axis deviation, ST-segment abnormalities, Left and right ventricular hypertrophy, Left bundle branch block, Atrial- and Ventricular premature beats were significantly higher in Hypotensive group. While On the other hand, Q-wave and Right atrial enlargement were significantly higher in Hypertensive group.