Orthostatic Hypotension and Blood Pressure Variability in Persons Undergoing Hemodialysis - an Observational Study

Background: Hypertension is an independent risk factor for development of end-stage renal disease and is the leading risk factor for cardiorenal death. It is estimated that more than 80% of patients with end-stage renal disease who undergo maintenance hemodialysis have hypertension. Intensified blood pressure control has been associated with reduced risk of death in patients with hypertension and chronic kidney disease but may increase the risk for intra-dialytic blood pressure falls in patients who undergo hemodialysis. Hemodialysis-associated hypotension has been associated with increased risks for cardiovascular disease and mortality.

Aim: The aim of this observational pilot study is to evaluate whether point-of-care ultrasound measurements may predict intradialytic hypotension and orthostatic blood pressure falls, in patients with chronic kidney disease who undergo maintenance hemodialysis.

Ethics: The study has been approved by the Swedish Ethical Review Authority (2023-05959-01).

Study participants: All patients (n=70) with chronic kidney disease who undergo maintenance hemodialysis at Vrinnevi Hospital in Norrköping, Sweden, will be invited to voluntarily participate in the study. Information about the study will be given orally and in written form. Those who opt to participate will be asked to sign a written informed consent.

Background data collection: For descriptive purposes, information will be collected regarding current and prior medical diagnoses, current medical treatment, anthropometric data, and self-perceived quality of lite (using the validated questionnaire KDQOL-SF). Blood samples will be tested for routine hematological variables, as well as for sodium, potassium, calcium, creatinine, urea and HbA1c.