Intra-Dialytique Hypotension: Prevalence and Associated Factors in 2 Haemodialysis Centres in Senegal

Abstract

Introduction: This study aimed to assess the prevalence of Intra-dialytic hypotension (IDH) according to the European Best Practice Guidelines (EBPG) definition in relation to the number of haemodialysis sessions and the number of chronic haemodialysis patients and to identify its associated factors. Patients and Methods: We conducted an observational, multicentre and looking-forward study of descriptive and analytical purposes over a 4-week period. The study included all patients with regular chronic haemodialysis with at least two sessions per week and a duration of 180 minutes, who consented to participate in the study and were over 15 years of age. Data collection was done with pre-established forms. The following data were collected: blood pressure before each session, at 30, 60, 120, 180 and 240 minutes of each session; socio-demographic data; dialysis data; clinical, paraclinical, therapeutic data and nursing interventions. Results: The mean age of the patients was 43.84 ± 12.10 years. Among 568 haemodialysis sessions recorded in 50 patients, IDH was noted in 12 haemodialysis sessions, representing a prevalence of 2.11%. Fatigue was found in 5 sessions with IDH episodes (41.66%) followed by yawning (25%), nausea ± vomiting (16.66%) and cramps (16.66%). As nursing interventions, Trendelenburg position and normal saline administration were performed in all IDH episodes. High blood pressure, inter-dialytic weight gain greater than 3 kg, Uf/H > 10 ml/kg/H, anaemia and hypoalbuminaemia were associated with the occurrence of IDH. Conclusion: The prevalence of IDH according to the EBPG definition is low. However, it is an important cause of morbidity and mortality, especially cardiovascular involvement, and the factors associated with its presence have been clearly identified.