Association of intradialytic hypertension and antihypertensive medication use in patients undergoing maintenance hemodialysis: a prospective observational study [version 1; peer review: awaiting peer review]

Background In patients with end-stage kidney disease (ESKD) undergoing maintenance hemodialysis, intradialytic hypertension and intradialytic hypotension are the common complications. The study aimed to collect and assess intradialytic Blood Pressure (BP) complications and their association with different factors, including BP medication. Methods This was a prospective observational study, conducted at the hemodialysis center in a teaching hospital in the UAE, that provide a specialist’s care for the patients receiving ongoing hemodialysis. Patient demographics, medications used, lab data and the peridialytic BP (pre-, intra-, and post-) dialytic BP were collected for a period of 6 months. SPSS Version 29, Armonk, NY was used for statistical analysis. Pearson Chi-square test and Fischer’s Exact test were used to compare the association between categorical variables to intradialytic hypertension and hypotension. Results Blood pressure data was collected from 47 hemodialysis patients for a total of 2616 hemodialysis sessions during the 6 months study period. Beta-blockers (68%) and calcium channel blockers (66%) were the commonly used antihypertensive medications in the study population. Intradialytic hypertension events were diagnosed in 49 hemodialysis sessions and intradialytic hypotension was diagnosed in 23 hemodialysis sessions. On comparing the effect of antihypertensive medication to the occurrence of intradialytic BP complications, ARBs and alpha-1 blockers showed no association to intradialytic hypertension, but beta-blockers and calcium channel blockers use were associated with increased number of intradialytic hypertension events (p-value Conclusions Patients using ARBs or alpha-1 blockers had higher intradialytic hypertension events. Beta-blocker and calcium channel users had lower intradialytic hypertension events. Antihypertensive use showed no association with intradialytic hypotension events.