EFFICACY OF INTRADIALYTIC HYPOTENSION AMONG END STAGE RENAL DISEASE PATIENTS UNDERGOING CONVENTIONAL MAINTAINANCE HEMODIALYSIS

Abstract

Background: Intradialytic hypotension remains one of the most frequent complications during hemodialysis, affecting somewhere between 5% to 40% of patients depending on the population and definition used. It happens when blood pressure drops sharply during treatment, which can lead to things like organ damage, longer hospital stays, and even higher mortality rates.

Objective: This study aimed to figure out whether certain patient characteristics and dialysis parameters could predict intradialytic hypotension in people with end stage renal disease who were getting regular maintenance hemodialysis. More specifically, we wanted to see if things like age, gender, body mass index, how long someone had been on dialysis, and some treatment settings had any real connection to IDH episodes.

Methods: We did a cross sectional study at Muhammad Sulman Khalid Hospital in Lahore, looking at 70 adult patients who had been on conventional maintenance hemodialysis for at least three months. Data collection took about four months.The gathered information on demographics, comorbidities, dialysis parameters, and clinical factors. Blood pressure was monitored during sessions to identify IDH episodes. For analysis we used SPSS 27, running chi-square tests, one way ANOVA, and ROC curve analysis to see what actually predicted IDH.

Results: The average age of our patients was 51.66 years and their mean BMI was pretty low at 18.54. Most had been on dialysis for around 2.22 years. Interestingly, IDH was a bit more common in males at 68.6% compared to 60% in females, but that difference wasn't statistically significant (p = .454). None of the individual factors we looked at really stood out on their own. Age had an AUC of .687 (p = .036) which was significant but not amazing, while BMI (.536, p = .892), blood flow rate (.621, p = .172), and dialysis duration (.456, p = .624) all failed to reach significance. However when we put everything together into a combined model, the ROC curve gave us an AUC of 0.856 (p < .001), which is actually pretty good.

Conclusion: No single clinical factor reliably predicted intradialytic hypotension by itself, but the combination of variables did a decent job at identifying at risk patients. Age showed some promise as a predictor, but honestly we need more research with larger samples to really nail down what works best.