CC BY-NC-ND 4.0 · J Lab Physicians 2010; 2(02): 066-069
DOI: 10.4103/0974-2727.72151
Original Article

Effect of Intradialytic Change in Plasma Volume on Blood Pressure in Patients Undergoing Maintenance Hemodialysis

Ali-Reza Khalaj
University of Social Welfare and Rehabilitation Sciences, Akhavan Center, Tehran, Iran
,
Suzan Sanavi
University of Social Welfare and Rehabilitation Sciences, Akhavan Center, Tehran, Iran
,
Reza Afshar
Shahed University, Mustafa Khomeini Hospital, Tehran, Iran
,
Muhammad-Reza Rajabi
Shahed University, Mustafa Khomeini Hospital, Tehran, Iran
› Author Affiliations
Source of Support: Nil

ABSTRACT

Background: Hypervolemia is a common complication in patients on hemodialysis (HD). To determine the effect of volume change on blood pressure in HD population, this cohort was conducted.

Materials and Methods: The study population was composed of 60 non-diabetic patients on maintenance HD, with mean age of 59.95±15.28 years. They were divided into hypertensive group A (n=26) and normotensive group B (n=34). Data were collected by a questionnaire. Pre and post-dialysis blood levels of urea, sodium, total protein, and hemoglobin were measured and intradialytic change of plasma volume were calculated. Data analyses were performed by the SPSS v.16.

Results: Out of 60 patients, 58.3% were male and 41.7% female. Post-dialysis systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly lower than pre-dialysis values in both groups (P=0.001, each). No correlation was found between intradialytic change in plasma volume or body weight and alterations of SBP or DBP during HD in the study groups (P>0.05, each). Intradialytic changes of body weight did not correlate to intradialytic changes of plasma volume (P=0.15).

Conclusion: HD effectively reduces blood pressure and volume expansion, however, intradialytic changes of plasma volume and body weight do not influence on SBP and DBP.



Publication History

Article published online:
29 January 2020

© 2010.

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  • REFERENCES

  • 1 Afshar R, Sanavi S, Salimi J. Epidemiology of chronic renal failure in Iran: A four year single-center experience. Saudi J Kidney Dis Transpl 2007;18:191-4.
  • 2 McClellan WM. Epidemiology and risk factors for chronic disease. Med Clin North Am 2005;89:419-45.
  • 3 Ross EA, Pittman TB, Koo LC. Strategy for the treatment of noncompliant hypertensive hemodialysis patients. Int J Artif Organs 2002;25:1061-5.
  • 4 Kocks MJ, de Zeeuw D, Navis GJ. Optimal blood pressure control and antihypertensive regimens in hypertensive renal disease: The potential of exploring the mechanisms of response variability. Curr Opin Nephrol Hypertens 2002;11:135-40.
  • 5 Zandu-Nejad K. Adult hypertension and kidney disease. Hypertension 2006;47:502-8.
  • 6 Zucchelli P, Santoro A, Zuccala A. Genesis and control of hypertension in hemodialysis patients. Semin Nephrol 1988;8:163-8.
  • 7 Converse RL Jr, Jacobsen TN, Toto RD, Jost CM, Cosentino F, Fouad-Tarazi F, et al. Sympathetic overactivity in patients with chronic renal failure. N Engl J Med 1992;327:1912-8.
  • 8 Dhondt AW, Vanholder RC, Ringoir SM. Angiotensin-converting enzyme inhibitors and higher erythropoietin requirement in chronic hemodialysis patients. Nephrol Dial Transplant 1995;10:2107-9.
  • 9 Rodriguez HJ, Domenici R, Diroll A, Goykhman I. Assessment of dry weight by monitoring changes in blood volume during hemodialysis using Crit-Line. Kidney Int 2005;68:854-61.
  • 10 Abraham PA, Opsahl JA, Keshaviah PR, Collins AJ, Whalen JJ, Asinger RW, Body fluid spaces and blood pressure in hemodialysis patients during amelioration of anemia with erythropoietin. Am J Kidney Dis 1990;16:438-46.
  • 11 Leypoldt JK, Cheung AK, Delmez JA, Gassman JJ, Levin NW, Lewis JA, et al.Relationship between volume status and blood pressure during chronic hemodialysis. Kidney Int 2002;61:266-75.
  • 12 NKF-DOQI Clinical Practice Guidelines for Hemodialysis Adequacy v. Hemodialysis dose troubleshooting. Am J Kidney Dis 2001;37:542.
  • 13 Brown MA, Whitworth JA. Hypertension in human renal disease. J Hypertens 1992;10:701-12.
  • 14 Brenner BM, Ballermann BJ, Gunning ME, Zeidel ML. Diverse biological actions of atrial natriuretic peptides. Physiol Rev 1990;70:665-99.
  • 15 Port FK, Hulbert-Shearon TE, Wolfe RA, Bloembergen WE, Golper TA, Agodoa LY, et al. Predialysis blood pressure and mortality risk in a national sample of maintenance hemodialysis patients. Am J Kidney Dis 1999;33:507-17.
  • 16 Michel JB. Renal artery obstruction: From experimental models to logical approach to diagnosis and treatment. Rev Prat 1996;46:1077-83.
  • 17 Luik AJ, Gladziwa U, Kooman JP, van Hooff JP, de Leeuw PW, van Bortel LM, et al. Influence of interdialytic weight gain on blood pressure in hemodialysis patients. Blood Purif 1994;12:259-66.
  • 18 Savage T, Fabbian F, Giles M, Tomson CR, Raine AE. Interdialytic weight gain and 48-h blood pressure in hemodialysis patients. Nephrol Dial Transplant 1997;12:2308-11.
  • 19 Luik AJ, Charra B, Katzarski K, Habets J, Cheriex EC, Menheere PP, et al. Blood pressure control and hemodynamic changes in patients on long time hemodialysis treatment. Blood Purif 1998;16:197-209.
  • 20 Ibrahim S, Taweel A. Influence of plasma volume status on blood pressure in patients on maintenance hemodialysis. Dial Transplant 2007;36:13-24.
  • 21 Lins LE, Hedenborg G, Jacobson SH, Samuelson K, Tedner B, Zetterholm UB, et al. Blood pressure reduction during hemodialysis correlates to interdialytic changes in plasma volume. Clin Nephrol 1992;37:308-13.
  • 22 Ventura J, Sposito M. Volume sensitivity of blood pressure in end stage renal disease. Nephrol Dial Transplant 1997;12:485-91.
  • 23 Rocco MV, Yan G, Heyka RJ, Benz R, Cheung AK, HEMO Study Group. Risk factors for hypertension in chronic hemodialysis patients: Baseline data from the HEMO study. Am J Nephrol 2001;21:280-8.
  • 24 Rahman M, Dixit A, Donley V, Gupta S, Hanslik T, Lacson E, et al. Factors associated with inadequate blood pressure control in hypertensive hemodialysis patients. Am J Kidney Dis 1999;33:498-506.
  • 25 Tabei K, Nagashima H, Imura O, Sakurai T, Asano Y. An index of plasma refilling in hemodialysis patients. Nephron 1996;74:266-74.
  • 26 Poldermans D, Man in 't Veld AJ, Rambaldi R, Van Den Meiracker AH, van Den Dorpel MA, Rocchi G, et al. Cardiac evaluation in hypotension-prone and hypotension-resistant hemodialysis patients. Kidney Int 1999;56:1905-11.