Impact of Hemodialysis Time Prolongation on Blood Pressure Control

Introduction: Hypertension prevalence among end-stage renal disease (ESRD) patients range from 76% to 90%. Increasing the duration of dialysis time, either by longer session hours or increased sessions, aiming at reducing the dry weight to achieve euvolemia, may be beneficial for individuals who failed to achieve target BP or ideal volume status during standard HD prescription hours. Objective: We aimed to study the effect of increasing hemodialysis session time on blood pressure control. Methods: This observational study was conducted on 50 hypertensive prevalent HD patients on thrice-weekly maintenance HD. Patients were divided into 2 groups: (A) 25 patients who received longer hemodialysis session (4.5 hours) and (B) 25 patients HD who received the usual 4 hours session. They were followed up for a period of 6 months to assess changes of pre-dialysis blood pressure to monitor response. Results: Ultrafiltration volume declined significantly with longer HD sessions compared to conventional sessions (p-value < 0.001 versus 0.523). Longer HD session time group was associated with highly significant decline in mean SBP, (p-value < 0.001). Moreover, longer HD session time group was associated with highly statistically significant decline in mean DBP, (p-value < 0.001). The decline in mean perdialysis SBP & DBP was -17.27 & -9 mmHg respectively and the rate of decline of postdialysis SBP & DBP was -6.45 & -12.38 mmHg respectively at 6th month compared to values in 1st month of follow up period. Conclusion: Longer HD session duration is associated with better improvement in UF volume, mean SBP & DBP, pre-dialysis SBP & DBP and post-dialysis SBP & DBP as well.