Overhydration Is a Risk Factor for Post-Dialysis Hypertension – Renal and Urology News

WASHINGTONPatients on hemodialysis (HD)patients who experience an increase in their extracellular water to total bodywater ratio (ECW/TBW) tend to develop post-dialysis hypertension and, in turn, heightentheir risks for early death, investigators reported at the American Society ofNephrologys Kidney Week 2019 meeting.

Of 254 prevalent HD patients (mean age 59years; 38% female), 29.1% had an increase in systolic blood pressure (SBP) of10 mm Hg or more after a midweek dialysis session based on bioimpedance analyses,Hyeong cheon Park, MD, of Gangnam Severance Hospital in South Korea, andcolleagues reported.

Compared with the nonhypertensive group,the hypertensive group was significantly older (64.3 vs 56.8 years) and morelikely to be using diuretics (45.9% vs 29.4%). The hypertensive group also had ahigher ECW/TBW ratio (0.400 vs 0.389), lower phase angle (4.4 vs 5.3), higher brainnatriuretic peptide (1034.1 vs 519.0 pg/mL), and lower albumin (3.8 vs 4.0mg/dL). Increased systolic blood pressure significantly correlated with increasedECW/TBW. In multiple logistic regression analysis, ECW/TBW was the onlyindependent risk factor affecting post-dialysis hypertension.

Individuals with post-dialysishypertension had significantly greater risks for all-cause mortality within 4years than more normotensive patients (30.2% vs 15.9%).

HD patients who experience frequentincrease in post-dialysis systolic blood pressure should be reassessed fortheir volume status and target dry weights, with emphasis on the ECW/TBW ratio,Dr Parks team concluded.

Reference

Park HY, Jung KS, Lee M, et al. OverhydrationIs an Independent Risk Factor for Postdialysis Hypertension and Predicts Mortalityin Hemodialysis Patients. Presented at: Kidney Week 2019. November 5-10, 2019. WashingtonDC. Poster TH-PO185.

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Overhydration Is a Risk Factor for Post-Dialysis Hypertension - Renal and Urology News