Intradialytic hypertension during chronic haemodialysis and subclinical fluid overload assessed by bioimpedance spectroscopy

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dc.contributor.authorSebastian, Sajithen_ZA
dc.contributor.authorFilmalter, Christelleen_ZA
dc.contributor.authorHarvey, Justinen_ZA
dc.contributor.authorChothia, Mogamat-Yazieden_ZA
dc.date.accessioned2017-08-07T07:09:17Z
dc.date.available2017-08-07T07:09:17Z
dc.date.issued2016-06-19
dc.descriptionCITATION: Sebastian, S., et al. 2016. Intradialytic hypertension during chronic haemodialysis and subclinical fluid overload assessed by bioimpedance spectroscopy. Clinical Kidney Journal, 9(4):636–643, doi:10.1093/ckj/sfw052.
dc.descriptionThe original publication is available at https://academic.oup.com
dc.description.abstractBackground: Intradialytic hypertension (IDH) increases morbidity and mortality. The prevalence in South Africa is unknown. The pathogenesis is unclear, but it has been suggested that IDH may be due to subclinical fluid overload. The objective of this study was to determine the prevalence of IDH and to evaluate its association with fluid overload using bioimpedance spectroscopy (BIS). Methods: A cross-sectional study involving 190 chronic haemodialysis patients in the Western Cape province of South Africa was conducted between January 2013 and May 2014. IDH was defined as a >10 mmHg increase in systolic blood pressure in at least four of six prior consecutive haemodialysis sessions. Results: The prevalence of IDH was 28.4% (n = 54). Therewas a trend towards pre-dialysis overhydration in the IDH group when compared with controls {2.6 L [95% confidence interval (CI) 1.7–3.4] versus 1.8 L [95% CI 1.4–2.1], respectively; P = 0.06} as measured by BIS, but no difference in mean ultrafiltration (UF) volume (2.4 versus 2.6 L; P = 0.30). A trend towards greater use of antihypertensive drugs was noted in the IDH group [2.5 drugs (95% CI 2.15–2.87) versus 2.1 (95% CI 1.82–2.30); P = 0.05]. More participants in the IDH group received calcium channel blockers (54 versus 36; P = 0.03). Conclusions: The prevalence of IDH in our treatment centres is much higher than previously reported. Subclinical fluid overload may be a major contributing factor to the mechanism of this condition. The use of BIS identifies patients who may benefit from additional UF.en_ZA
dc.description.urihttps://academic.oup.com/ckj/article/9/4/636/2918826/Intradialytic-hypertension-during-chronic?searchresult=1
dc.description.versionPublisher's version
dc.description.versionPublisher's version
dc.format.extent8 pages
dc.identifier.citationSebastian, S., et al. 2016. Intradialytic hypertension during chronic haemodialysis and subclinical fluid overload assessed by bioimpedance spectroscopy. Clinical Kidney Journal, 9(4):636–643, doi:10.1093/ckj/sfw052
dc.identifier.issn2048-8513 (online)
dc.identifier.issn2048-8505 (print)
dc.identifier.otherdoi:10.1093/ckj/sfw052
dc.identifier.urihttp://hdl.handle.net/10019.1/102060
dc.language.isoen_ZAen_ZA
dc.publisherOxford University Press European Renal Association
dc.rights.holderAuthors retain copyright
dc.subjectIntradialytic hypertensionen_ZA
dc.subjectBioimpedance monitoringen_ZA
dc.subjectRenal hypertensionen_ZA
dc.subjectHemodialysis patientsen_ZA
dc.titleIntradialytic hypertension during chronic haemodialysis and subclinical fluid overload assessed by bioimpedance spectroscopyen_ZA
dc.typeArticleen_ZA
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