Okoye Ogochukwu Chinedum, Slater Henry Enyinmisan, Rajora Nilum
Nephrology Division, Department of Medicine, Delta State University Teaching Hospital, Nigeria.
Nephrology Division, UT Southwestern Medical Centre, Dallas Texas, USA.
Pan Afr Med J. 2017 Sep 21;28:62. doi: 10.11604/pamj.2017.28.62.13743. eCollection 2017.
Intra-dialytic hypotension (IDH) is a common complication of haemodialysis that impacts negatively on the patient's quality of life and can induce serious cardiovascular events.
Records of all adults who had haemodialysis treatments from Jan 2012-Jan 2016 were reviewed. Socio-demographic data, health status of patient, aetiology of renal disease, clinical and biochemical parameters such as systolic and diastolic blood pressures (SBP and DBP), packed cell volume, were collated using Microsoft Excel.
The overall prevalence of intra-dialytic hypotension was 8.6%. Of all haemodialysis patients, 45.7% experienced a drop in SBP > 20mmHg, 28.5% required nurses' intervention and 8.6% had symptoms. Diagnosis of obstructive nephropathy (OR: 3.1, CI:1.43-6.60, p = < 0.004) and sepsis (OR: 3.57, CI: 1.31- 9.75, P = 0.013) increased the odds of experiencing IDH. Only 5% of patients with predialysis SBP < 100mmHg developed IDH (OR: 0.12, CI: 0.02-0.93, P = 0.04).
IDH was common among the patients studied. It was more prevalent among patients with obstructive nephropathy and sepsis; however other traditional risk factors of IDH such as older age and anaemia, were not found to be significantly associated with IDH. Surprisingly, prevalence of IDH was significantly less among patients with pre-dialysis hypotension compared to those without.
透析中低血压（IDH）是血液透析的常见并发症，对患者生活质量有负面影响，并可诱发严重心血管事件。
回顾了2012年1月至2016年1月期间所有接受血液透析治疗的成年人的记录。使用Microsoft Excel整理社会人口统计学数据、患者健康状况、肾脏疾病病因、临床和生化参数，如收缩压和舒张压（SBP和DBP）、血细胞比容。
透析中低血压的总体患病率为8.6%。在所有血液透析患者中，45.7%的患者收缩压下降>20mmHg，28.5%的患者需要护士干预，8.6%的患者出现症状。梗阻性肾病（OR：3.1，CI：1.43 - 6.60，p = < 0.004）和脓毒症（OR：3.57，CI：1.31 - 9.75，P = 0.013）增加了发生IDH的几率。透析前收缩压<100mmHg的患者中只有5%发生IDH（OR：0.12，CI：0.02 - 0.93，P = 0.04）。
IDH在所研究的患者中很常见。在梗阻性肾病和脓毒症患者中更为普遍；然而，未发现IDH的其他传统危险因素，如老年和贫血，与IDH有显著相关性。令人惊讶的是，与无透析前低血压的患者相比，透析前低血压患者的IDH患病率显著较低。
