Intradialytic Hypertension and Associated Factors among Chronic Haemodialysed Patients in Sub-Saharan Africa: An Example from Cameroon

Abstract

Background: Hemodialysis (HD) is a therapy during which complications such as intradialytic hypertension (IDH) are frequent. We aimed to determine the incidence of IDH and associated factors amongst patients on maintenance hemodialysis in Cameroon. Method: It was a prospective cohort study including end stage kidney disease patients on HD. Data collected were: socio-demographic, comorbidities, current medication, weight, heart rate ultrafiltration rate (UF), albuminemia and electrocardiogram. The first blood pressure (BP) measurement was obtained at the beginning of the session and the last at the end. IDH was defined as an increase in systolic BP ≥ 10 mmHg between the first and the last measurement. Logistic regression was used to look for associated factors, p-value < 0.05 was considered significant. Results: Mean age was 49.06 ± 13.97 years with 64.2% males. Mean number of dialysis session was 11.26 ± 2.49. Incidence of IDH was 48.36%. The median number of IDH episodes was 5 (Range 0 - 12). Factors increasing the risk were hypertension (p = 0.003), number of antihypertensive drugs ≥ 2 (p < 0.001), blood transfusion during the session (p < 0.001), male gender (p = 0.038) and a monthly income < 35000 XAF (p = 0.033). Factors lowering the risk were age ≥ 50 years (p = 0.012), longer duration on dialysis (p < 0.001), dry weight ≥ 67 kg (p < 0.001), UF ≥ 800 ml/h (p < 0.001) and a BP ≥ 140/90 mmHg at the beginning of the session (p < 0.001). Conclusion: IDH is frequent amongst patients on maintenance hemodialysis in our setting, with various patients related factors associated.