Van Buren Peter N, Kim Catherine, Toto Robert D, Inrig Jula K
Department of Internal Medicine, Division of Nephrology, University of Texas Southwestern Medical Center, Dallas, TX 75390-8856, USA.
Int J Artif Organs. 2012 Dec;35(12):1031-8. doi: 10.5301/ijao.5000126.
Intradialytic hypertension, a phenomenon where blood pressure increases during hemodialysis, is associated with increased mortality in hemodialysis patients. The proportion of patients in which intradialytic hypertension persists over time is unknown.
In a retrospective cohort study, we studied all patients from our outpatient hemodialysis units that received =1 month of treatments during the period from January to August 2010. We reviewed all pre- and post-hemodialysis blood pressure and weight measurements from 22,955 treatments during this study period. We defined intradialytic hypertension as an increase in systolic blood pressure =10 mmHg from pre- to post-hemodialysis. Individual patients were defined as having persistent intradialytic hypertension if the change in blood pressure from pre- to post-hemodialysis, when averaged throughout the study period, was =+10 mmHg. We calculated weight changes between and during hemodialysis and defined ultrafiltration rate per treatment as ultrafiltration volume divided by minutes on hemodialysis. We compared patients with and without persistent intradialytic hypertension using chi-square analysis and mixed linear models.
The prevalence of intradialytic hypertension was 21.3 per 100 treatments. The median percentage of intradialytic hypertension treatments per patient was 17.8% (9-31.3%, interquartile range). The prevalence of persistent intradialytic hypertension was 8 per 100 patients. Patients with persistent intradialytic hypertension had lower ultrafiltration rate compared to other patients (10.4 vs. 12.2 ml/min, p = 0.02).
Intradialytic hypertension is a persistent phenomenon in a subset of hemodialysis patients. Ultrafiltration rate was the only volume-related variable that differed between patients with and without persistent intradialytic hypertension.
透析期间高血压是指血液透析过程中血压升高的现象，与血液透析患者死亡率增加相关。随着时间推移仍持续存在透析期间高血压的患者比例尚不清楚。
在一项回顾性队列研究中，我们研究了2010年1月至8月期间在我们门诊血液透析单元接受≥1个月治疗的所有患者。我们回顾了该研究期间22955次治疗的所有透析前和透析后血压及体重测量值。我们将透析期间高血压定义为透析后收缩压较透析前升高≥10 mmHg。如果在整个研究期间平均计算，透析前至透析后血压变化≥+10 mmHg，则个体患者被定义为患有持续性透析期间高血压。我们计算了透析期间及透析前后的体重变化，并将每次治疗的超滤率定义为超滤量除以血液透析时间（分钟）。我们使用卡方分析和混合线性模型比较了有和没有持续性透析期间高血压的患者。
透析期间高血压的患病率为每100次治疗21.3例。每位患者透析期间高血压治疗的中位数百分比为17.8%（9 - 31.3%，四分位间距）。持续性透析期间高血压的患病率为每100例患者8例。与其他患者相比，患有持续性透析期间高血压的患者超滤率较低（10.4 vs. 12.2 ml/分钟，p = 0.02）。
透析期间高血压在一部分血液透析患者中是一种持续存在的现象。超滤率是有和没有持续性透析期间高血压的患者之间唯一存在差异的容量相关变量。
