Efficacy of Progressive Ultrafiltration in Managing Intradialytic Hypertension among Hemodialysis Patients

Introduction: Intra-dialytic hypertension (IDH) is a condition linked with heightened risk of adverse cardiovascular outcomes for patients on maintenance haemodialysis. Our study aims to evaluate the efficacy and tolerability of intensified ultrafiltration (UF) progressively as a therapeutic intervention for IDH and to discern its effectiveness in managing this condition.Subjects and methods: A Prospective, descriptive study was conducted over a six-month period in the Nephrology department in Karachi, Pakistan from May 07, 2023, to November 07, 2023. Initially, one hundred participants with IDH and pre-haemodialysis blood pressure below 140 mm-Hg were included. Pre- and post-dialysis blood pressure readings were taken, with a target of one litre increase in UF rates applied over a period of two weeks. Effectiveness was evaluated post-dialysis as a systolic blood pressure drop of at least 10 mm Hg and sustained for 12 weeks.Results: Of the 100 participants enrolled, 40 were withdrawn from the study due to intolerance to UF escalation. The mean age was 57.37 ± 8.92 years with male predominance of 79.1%. Among the remaining 60 participants, 70% showed a significant a reduction in blood pressure of at least 10mm Hg by the conclusion of their treatment sessions. Patients under the age of 60, males and diabetics had a statistically significant correlation (p = 0.0005, 0.015, 0.01 respectively).Conclusion: A significant correlation was observed between the reduction in IDH and the use of intensified, gradual UF. To further elucidate the efficacy of progressive ultrafiltration in managing intra-dialytic hypertension among haemodialysis patients, more comprehensive research is warranted.