RAHMARIANI, FITRI and Ali, Zulkhair and Liberty, Iche Andriyani (2025) INTRADIALYTIC HYPERTENSION AS A PREDICTOR OF CARDIOVASCULAR HOSPITALIZATION IN CHRONIC HEMODIALYSIS PATIENTS AT DR. MOHAMMAD HOESIN GENERAL HOSPITAL PALEMBANG. Other thesis, Sriwijaya University.
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Abstract
Background: Intradialytic hypertension (IDH) is a common clinical phenomenon among patients receiving maintenance hemodialysis patients and has been associated with increased cardiovascular morbidity and mortality. However, a widely accepted, evidence-based definition, particularly one with validated prognostic value, remains uncertain. This study evaluated the association between intradialytic hypertension and cardiovascular hospitalization and identified the definition with the strongest prognostic performance in chronic hemodialysis patients at RSMH Palembang. Methods: We conducted a retrospective observational study among patients undergoing maintenance hemodialysis at RSMH Palembang. Data were extracted from medical records, including patient characteristics, pre- and post-dialysis blood pressure measurement, and hospitalization for cardiovascular causes over a 6-month follow-up. Intradialytic hypertension was defined using three non-mutually exclusive threshold for the pre- to post-dialysis increase in systolic blood pressure (SBP), ≥5 mmHg (Hyper5), ≥10 mmHg (Hyper10), and ≥20 mmHg (Hyper20), each required in at least four of six consecutive dialysis session. Associations were examined using bivariable test and mutivariable cox regression; prognostic discrimination was quantified with Harrell’s concordance index and Somers’ D. Results: A total of 149 subjects were included in the final analysis. Most participants were under 60 years of age, female, and had hypertension and diabetes mellitus; baseline characteristics did not differ significantly between IDH and non-IDH groups (p>0,05). The most frequent cardiovascular hospitalization events were acute pulmonary edema and hypertensive crisis, both more common in the IDH group (p<0,05). Intradialytic hypertension, defined by Hyper5, Hyper10, and Hyper20, was significantly associated with a higher 6-month incidence of cardiovascular hospitalization. Among these thresholds, Hyper10 demonstrated the best prognostic performance for cardiovascular hospitalization (Harrell’s C=0.68; Somers’ D=0.37; p<0.001), outperforming Hyper5 and Hyper20. Conclusion: In patients receiving maintenance hemodialysis, intradialytic hypertension is associated with an increased ris of cardiovascular hospitalization over 6 months. Defining intradialytic hypertension as a ≥10 mmHg rise in SBP from pre- to post-dialysis (Hyper10) provides a practical and prognostically informative threshold for risk stratification. Keywords: intradialytic hypertension, chronic hemodialysis, cardiovascular hospitalization, systolic blood pressure, prognostic value
| Item Type: | Thesis (Other) |
|---|---|
| Uncontrolled Keywords: | Intradialytic Hypertension, Hemodialysis, Chronic Kidney Disease, Cardiovascular Hospitalization, Cardiovascular Outcomes, Blood Pressure Variability, End-Stage Renal Disease (ESRD), Endothelial Dysfunction, Volume Overload, Arterial Stiffness, Sympathetic Nervous System Activation, Renin-Angiotensin-Aldosterone System (RAAS), Uremic Toxins, Oxidative Stress, Inflammation, Left Ventricular Hypertrophy (LVH), Cardiovascular Morbidity and Mortality, Dialysis-related Complications, Risk Factors, Prognosis |
| Subjects: | R Medicine > RC Internal medicine > RC31-1245 Internal medicine R Medicine > RC Internal medicine > RC581-951 Specialties of internal medicine R Medicine > RC Internal medicine > RC666-701 Diseases of the circulatory (Cardiovascular) system R Medicine > RC Internal medicine > RC870-923 Diseases of the genitourinary system. Urology |
| Divisions: | 04-Faculty of Medicine > 11702-Internal Medicine (Sp |
| Depositing User: | Fitri Rahmariani |
| Date Deposited: | 12 Sep 2025 06:54 |
| Last Modified: | 12 Sep 2025 06:54 |
| URI: | http://repository.unsri.ac.id/id/eprint/183862 |
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