Egbi Oghenekaro Godwin, Daz Ahmed Sulaiman
Nephrology Unit, Department of Medicine, Rainbow Dialysis Centre, Niger Delta University Teaching Hospital, Yenagoa, Bayelsa State, Nigeria.
Nephrology Unit, Department of Medicine, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria.
Niger Med J. 2019 Nov-Dec;60(6):290-294. doi: 10.4103/nmj.NMJ_76_19. Epub 2020 Feb 24.
Hemodialysis (HD) is a common modality of renal replacement therapy in Nigeria. Despite its usefulness, it may have complications such as intra-dialytic hypotension (IDH) and intra-dialytic hypertension (IDHTN), both of which may impact negatively on the patient. The aim of the study was to examine blood pressure (BP) changes during HD, to determine the frequency of IDH and IDHTN in patients undergoing HD, and to possibly identify associated factors.
The study design was a retrospective review of records of patients who had HD in the Rainbow Dialysis Center, a foremost private dialysis center in Bayelsa State. The records of all adults who had HD in the center from June 2014 to June 2018 were reviewed. Data retrieved include sociodemographics, type and cause of renal disease, and clinical and laboratory parameters such as BPs, packed cell volume, urea, and creatinine.
Data were analyzed with SPSS version 20.0. Data were presented in tabular forms. Variables were expressed as mean with standard deviation, frequencies, and percentages. The means were compared using Student's -test or analysis of variance where appropriate. Chi-square test was used to compare proportions. Statistical significance was set at < 0.05.
One hundred and thirty-six cases were recruited for the study. IDH and IDHTN were found in 16.9% and 16.2% of the patients, respectively. There was no significant difference between the mean predialysis and postdialysis systolic, diastolic, mean arterial BP, or pulse pressure ( > 0.05). Older age was positively and significantly associated with IDHTN ( = 0.047).
IDH and IDHTN were prevalent among the patients studied, with the latter being slightly more likely to occur with advancing age. There is a need for adequate BP monitoring and management during HD.
血液透析(HD)是尼日利亚肾脏替代治疗的常见方式。尽管其有用,但可能会出现诸如透析中低血压(IDH)和透析中高血压(IDHTN)等并发症,这两者都可能对患者产生负面影响。本研究的目的是检查血液透析期间的血压(BP)变化,确定接受血液透析患者中IDH和IDHTN的发生率,并可能识别相关因素。
本研究设计为对位于巴耶尔萨州一家主要的私立透析中心——彩虹透析中心接受血液透析患者的记录进行回顾性分析。回顾了2014年6月至2018年6月期间在该中心接受血液透析的所有成年人的记录。检索到的数据包括社会人口统计学、肾脏疾病类型和病因,以及临床和实验室参数,如血压、血细胞比容、尿素和肌酐。
数据采用SPSS 20.0版进行分析。数据以表格形式呈现。变量以平均值±标准差、频率和百分比表示。在适当情况下,使用学生t检验或方差分析比较平均值。使用卡方检验比较比例。统计学显著性设定为P<0.05。
本研究共纳入136例病例。分别在16.9%和16.2%的患者中发现了IDH和IDHTN。透析前和透析后收缩压、舒张压、平均动脉压或脉压的平均值之间无显著差异(P>0.05)。年龄较大与IDHTN呈正相关且具有显著性(P = 0.047)。
IDH和IDHTN在所研究的患者中普遍存在,后者随着年龄增长发生的可能性略高。在血液透析期间需要进行充分的血压监测和管理。