A Cross-sectional Study on Intradialytic Hypertension at Four Haemodialysis Units in the Western Cape, South Africa
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 200
- 试验地点
- 1
- 主要终点
- Prevalence of intradialytic hypertension at four haemodialysis units in the Western Cape
研究概览
简要总结
Observational evidence indicates that intradialytic hypertension is associated with high morbidity & mortality. The investigators impression is that this problem may be more prevalent than initially suspected. To the investigators knowledge, there are no studies on intradialytic hypertension in the South African haemodialysis population.
详细描述
Introduction
Intradialytic hypertension (IDH) is the paradoxical rise in blood pressure (BP) during or immediately after haemodialysis.
Nephrologists have yet to arrive at a standard definition of IDH. Definitions vary widely from systolic blood pressure rises of ≥ 10mmHg, rise in mean arterial pressure (MAP) during dialysis > 15mmHg to hypertension that appears resistant to ultrafiltration during or immediately after dialysis.1 Depending on the definition used, the prevalence of IDH varies between 5-15%.
This phenomenon may appear trivial to the inexperienced doctor. However, IDH increases the risk of hospitalization and death as reported in the Crit-Line Intradialytic Monitoring Benefit Study (CLIMB) and United States Renal Data System (USRDS) haemodialysis study.
The pathogenesis of IDH is unclear. A number of factors have been implicated and probably work synergistically to promote the rise in BP. These include: subclinical volume overload, activation of the sympathetic and renin-angiotensin-aldosterone systems, endothelial dysfunction, sodium gain during dialysis, use of erythropoietin stimulating agents (ESAs) and removal of anti-hypertensive agents during dialysis.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Control
- 时间视角
- Cross Sectional
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Males and females age > 18 years
- •Ability to give informed consent
排除标准
- •Inability to take blood pressure by routine methods in the upper limbs
- •Inability to give informed consent
- •Contraindications to bioimpedance monitoring (pre-existing implanted cardiac devices such as pacemakers, cardioverter defibrillators; amputees)
- •Intercurrent acute illness
结局指标
主要结局
Prevalence of intradialytic hypertension at four haemodialysis units in the Western Cape
时间窗: Up to 1 year
次要结局
- Participants pre- and post hemodialysis bioimpedance measurements(Up to 1 year)
研究者
Mogamat-Yazied Chothia
Consultant Nephrologist
University of Stellenbosch