High Ultrafiltration Increasing Intradialytic Blood Pressure on Hemodialysis Patients

Yunie Armiyati(1*), Suharyo Hadisaputro(2), Shofa Chasani(3), Untung Sujianto(4)


(1) Universitas Muhammadiyah Semarang; Doctoral Program, Faculty of Medicine, Universitas Diponegoro
(2) Postgraduate Program of Health Polytechnic of Semarang
(3) Hemodialysis Center, Roemani Hospital; Faculty of Medicine, Universitas Muhammadiyah Semarang
(4) Department of Nursing, Faculty of Medicine, Universitas Diponegoro
(*) Corresponding Author

Abstract


The increase in blood pressure when the patient is undergoing hemodialysis is experienced by patients with intradialytic hypertension. This condition can be very dangerous for the patient, must be prevented and needs to be controlled. Prevention can be done by controlling variables that can affect intradialytic blood pressure, including ultrafiltration during hemodialysis. This study aims to analyze the relationship between ultrafiltration (ultrafiltration goal, ultrafiltration rate) and intradialytic blood pressure. This research was a descriptive-analytic study with a cross-sectional design, with 112 samples at two centres of dialysis in Semarang. Data were analyzed using the Spearman Rho. The finding obtained showed that ultrafiltration goal (UFG) and ultrafiltration rate (UFR) correlated with intradialytic blood pressure (systolic, diastolic and mean arterial pressure). The magnitude of UFG an associated with increase in intradialytic systolic (p=0,024; r=0,213), increase in intradialytic diastolic (p=0,007; r=0,252) and increase in mean arterial pressure (p=0,016; r=0,227). High UFR is associated with with increase in intradialytic systolic (p=0,037; r=0,211), increase in intradialytic diastolic (p=0,001; r=0,320) and increase in mean arterial pressure (p=0,034; r=0,200). Determination of ultrafiltration during hemodialysis must be done carefully and precisely to prevent an increase in intradialytic blood pressure.


Keywords


Hemodialysis; Ultrafiltration; Intradialytic blood pressure

Full Text:

PDF

References


Steddon S, Chesser A, Cunningham J, et al. Oxford handbook of nephrology and hypertension. Oxford University Press, 2014.

Hinkle JL and Cheever KH. Brunner and Suddarth's textbook of medical surgical nursing. In: Squazzo K, (ed.). 14th ed. Philadelphia: Wolters Kluwer, 2018, p. 6112.

Kallenbach JZ. Review of Hemodialysis for Nurses and Dialysis Personnel-E-Book. Elsevier Health Sciences, 2015.

Buren PNV, Kim C, Toto RD, et al. The prevalence of persistent intradialytic hypertension in a hemodialysis population with extended follow-up. Int J Artif Organs 2012; 35: 1031-1038. 2012/10/16. DOI: 10.5301/ijao.5000126.

Kandarini Y. Peran ultrafiltrasi terhadap hipertensi intradialitik dan hubungannya perubahan kadar: endothelin-1, asymmetric dimethylarginin dan nitric oxide. Disertasi, Universitas Airlangg, 2012.

Armiyati Y. Hipotensi dan hipertensi intradialisis pada Pasien Chronic Kidney Disease (CKD) saat menjalani hemodialisis di RS PKU Muhammadiyah Yogyakarta. In: Prosiding Seminar Nasional Unimus Semarang, 2012, pp.126-135.

Chazot C and Jean G. Intradialytic hypertension: it is time to act. Nephron Clinical Practice 2010; 115: c182-c188.

Cheng Y, Li Y, Zhang F, et al. Interdialytic blood pressure variability and the risk of stroke in maintenance hemodialysis patients. 2020; 99.

NKF. Update of the KDOQI clinical practice guideline for hemodialysis adequacy. Minessota: National Kidney Foundation, 2015.

Agarwal R and Light RP. Intradialytic hypertension is a marker of volume excess. Nephrology Dialysis Transplantation 2010; 25: 3355-3361.

Suwitra K. Penyakit Ginjal Kronik. In: Sudoyo AW, Setiyohadi B, Alwi I, et al. (eds) Buku Ajar Ilmu Penyakit Dalam. 6 ed. Jakarta: FK-UI, 2014, pp.570-573.

Locatelli F, Cavalli A and Tucci B. The growing problem of intradialytic hypertension. Nature Reviews Nephrology 2010; 6: 41.

Smeltzer SC, Bare BG, Hinkle JL, et al. Brunner & Suddarth's textbook of medical-surgical nursing. 13th ed.: Lippincott Williams & Wilkins, 2013.

Buren PNV and Inrig JK. Mechanisms and treatment of intradialytic hypertension. Blood purification 2016; 41: 188-193.

Zhang Y, Zhang X, Li J, et al. Dry-weight reduction improves intradialytic hypertension only in patients with high predialytic blood pressure. Blood Press Monit 2019; 24: 185-190. 2019/02/27. DOI: 10.1097/MBP.0000000000000373.

Johan A. Hubungan besar ultrafiltrasi saat hemodialisis dengan kejadian peningkatan tekanan darah intradialitik pada pasien Gagal Ginjal Kronik. UNS, Surakarta, 2016.

Flythe JE, Kimmel SE and Brunelli SM. Rapid fluid removal during dialysis is associated with cardiovascular morbidity and mortality. Kidney international 2011; 79: 250-257.

Kim TW, Chang TI, Kim TH, et al. Association of ultrafiltration rate with mortality in incident hemodialysis patients. 2018; 139: 13-22.

Buren PNV. Pathophysiology and implications of intradialytic hypertension. Curr Opin Nephrol Hypertens 2017; 26: 303-310. 2017/04/12. DOI: 10.1097/MNH.0000000000000334.

Cirit M, Akcicek F, Terzioğlu E, et al. ‘Paradoxical’rise in blood pressure during ultrafiltration in dialysis patients. Nephrology Dialysis Transplantation 1995; 10: 1417-1420.

Chou K-J, Lee P-T, Chen C-L, et al. Physiological changes during hemodialysis in patients with intradialysis hypertension. Kidney international 2006; 69: 1833-1838.

Gũnal A, Karaca I, Celiker H, et al. Paradoxical rise in blood pressure during ultrafiltration is caused by increased cardiac output. Journal of nephrology 2002; 15: 42-47.


Article Metrics

Abstract view : 703 times
PDF - 106 times

DOI: https://doi.org/10.26714/seanr.3.1.2021.8-15

Refbacks

  • There are currently no refbacks.


Copyright (c) 2021 Yunie Armiyati, Suharyo Hadisaputro, Shofa Chasani, Untung Sujianto

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

View My Stats

Universitas Muhammadiyah Semarang

Kedungmundu Raya Street No. 18 Semarang, NRC Building Universitas Muhammadiyah Semarang

Phone: 02476740287
Fax: 02476740287
Email: [email protected]