الفهرس 
THE GROWING PROBLEM OF INTRADIALYTIC HYPERTENSIONOnly 14 pages are availabe for public view
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Abstract
Intradialytic hypertension, defined as an increase in systolic BP during hemodialysis (HD), is a relatively common problem observed in about 15% of the maintenance HD population. It is an independent predictor of adverse clinical outcomes.
Patients and Methods
In this study we studied the role of endothelial dysfunction and dialysate sodium in the development of intradialytic hypertensionFifty hemodialysis patients who are regularly doing hemodialysis are selected. First all patients underwent a 3 hours session of ultrafiltration only .Then dialysis only then both dialysis and ultrafiltration during which blood pressure measurement and blood sample for renal function tests, albumin, endothelin -1 (pre and post procedure), nitric oxide (pre and post procedure)are checked
Results
There was a statistically significant higher mean endothelin-1 in dialysis (14.8pg/ml) compared to ultrafiltration and regular hemodialysis (6.4pg/ml,4.5pg/ml respectively) and there was a higher mean nitric oxide in ultrafiltration technique (198.9umol/l ) compared to other techniques and the difference was highly significant statistically. There was a higher mean systolic and diastolic blood pressures in both dialysis and regular hemodialysis techniques (185.1/96.5 mmHg and 174.8/96.3 mmHg respectively) compared to the ultrafiltration technique (96.5 mmHg, 88.6mmHg) and the difference was highly significant. Also we found that in dialysis technique there was a 15.2% rise in the mean systolic blood pressure and a 7.2% rise in the mean diastolic blood pressure that not evident while doing ultrafiltration. There was a highly significant positive correlation between the difference in systolic BP and difference in sodium level and a highly significant positive correlation between the difference in systolic BP and difference in endothelin level.
In conclusion, the present study confirms the important role of increased extracellular volume overload, endothelial dysfunction and dialysate exposure in the development of intradialytic hypertension
Key words: intradialytic hypertension, endothelin,