Characteristic Of Dialysis Patient With Intradialytic Hypertension In Hemodialysis Unit Sumedang Regional Public Hospital-1.docx

Characteristic of Dialysis Patient with Intradialytic Hypertension in Hemodialysis Unit Sumedang Regional Public Hospital Dya P. Andryan1, Ariseno1, Andri Mulya2 1 General Practicioner in Sumedang Regional Public Hospital 2 Internist in Sumedang Regional Public Hospital Background Intradialytic hypertension (IDH) defined as increased systolic blood pressure more 10 mmHg. Prevalence of IDH occurs in 5-15% patients. Mechanism of IDH still poorly understood but apparently related to subclinical fluid overload & endothelial dysfunction. IDH associated with increased hospitalization and higher mortality. It is important to identify patient it so we could implement different approach to patient. Objective Identify number and characteristic of dialysis patient with IDH in hemodialysis unit of Sumedang Regional Public Hospital. Method This was a retrospective cohort study. We studied patient who underwent routine dialysis session with evidence of IDH during last 5 dialysis session. Result From total 140 routine dialysis patient, 58 patient (41,4%) had IDH. From 58 patient, 28 IDH patient (48,2%) had baseline systolic blood pressure 140-159 mmH and 13 patient (22,4%) had it over 160 mmHg. Mean  systolic BP (SBP) was 21,4 mmHg. Interestingly 51 patient (87,9%) had Kt/V at least 1,2. 42 patient (72,4%) reached their dry weight at least 3 of 5 last session. Despite using antihypertension, 39 patient (67,2%) had baseline SBP > 140 mmHg. Almost all patient (98,2%) got less than 3 antihypertensive agent. Conclusion From 140 dialysis patient, 41,4% had IDH, higher than prevalence in general population. More than 70% had good adequacy & reached their dry weight and 67,2% IDH patient had baseline SBP >140mmHg. Based on this evidence, instead of fluid overload, less aggressive anti-hypertensive approach and endothelial dysfunction may be factor for causing IDH in hemodialysis unit Sumedang Regional Public Hospital. Keyword : intradialytic hypertension, blood pressure, hypertension, dialysis