Introduction: Hypertension, often associated with hypervolemia, is common in chronic hemodialysis patients. However, the relationship between interdialytic weight gain (IDWG) and blood pressure (BP) is incompletely characterized. Our study seeks to appreciate the relationship between IDWG and BP in a cohort of chronic hemodialysis patients. Patients and Methods: It is a prospective study involving 52 chronic hemodialysis patients and 528 dialysis sessions following a hemodialysis program of 3 times a week, where BP and IDWG were measured before the session. The dialysis sessions occurred over a period of 30 days from January 02 to 30, 2019 in the Hemodialysis unit of Mohammed V Military Training Hospital. Demographic data and dialytic parameters were collected over a 30-day period then analyzed using the following statistical tools: correlation coefficient r, simple linear regression (univariate analysis) and multiple linear regression (multivariate analysis). Results: Mean age was 55 ± 12 years, 48% were men, 32.7% were diabetic and 61.5% were on antihypertensive therapy. In univariate analysis, each 1 kg increase in IDWG was associated with an increase of 3.3 mmHg in systolic BP (p = 0.01) and 2.7 mmHg in diastolic BP (p = 0.006). In multivariate analysis, after adjusting for confounding factors, an increase of 1 kg of IDWG was associated with an increase of 1.7 mmHg of systolic BP (p = 0.05) and 1.8 mmHg of diastolic BP (p = 0.05). Conclusion: Our results show that there is a significant association between IDWG and BP, however, its modest magnitude can’t explain alone the variations of BP in the chronic hemodialysis patients.
Cite this paper
Sobhi, A. , Errihani, M. , Hassani, K. and Kabbaj, D. E. (2021). The Effect of Interdialytic Weight Gain on Blood Pressure in a Population of Chronic Hemodialysis Patients. Open Access Library Journal, 8, e7004. doi: http://dx.doi.org/10.4236/oalib.1107004.
Kalantar-Zadeh, K., Regidor, D.L., Kovesdy, C.P., Van Wyck, D., Bunnapradist, S., Horwich, T.B. and Fonarow, G.C. (2009) Fluid Retention Is Associated with Cardiovascular Mortality in Patients Undergoing Long-Term Hemodialysis. Circulation, 119, 671-679. https://doi.org/10.1161/CIRCULATIONAHA.108.807362
Inrig, J.K., Patel, U., Gillespie, B.S., Hasselblad, V., Himmelfarb, J., Reddan, D., et al. (2007) Relationship between Interdialytic Weight Gain and Blood Pressure among Prevalent Hemodialysis Patients. American Journal of Kidney Diseases, 50, 108-118.
Lopez-Gomez, J.M., Villaverde, M., Jofre, R., Rodriguez-Benítez, P. and Pérez-García, R. (2005) Interdialytic Weight Gain as a Marker of Blood Pressure, Nutrition, and Survival in Hemodialysis Patients. Kidney International, 67, S63-S68.
Ifudu, O., Uribarri, J., Rajwani, I., Vlacich, V., Reydel, K., Delosreyes, G. and Friedman, E.A. (2002) Relation between Interdialytic Weight Gain, Body Weight and Nutrition in Hemodialysis Patients. American Journal of Nephrology, 22, 363-368. https://doi.org/10.1159/000065228
Rodby, R.A., Vonesh, E.F. and Korbet, S.M. (1994) Blood Pressures in Hemodialysis and Peritoneal Dialysis Using Ambulatory Blood Pressure Monitoring. American Journal of Kidney Diseases, 23, 401-411.
Coomerrw, S.G., Schulman, G., Breyer, J.A. and Shyr, Y. (1997) Ambulatory Blood Pressure Monitoring in Dialysis Patients and Estimation of Mean Interdialytic Blood Pressure. American Journal of Kidney Diseases, 29, 678-684.
Krautzig, S., Janssen, U., Koch, K.M, Granolleras, C. and Shaldon, S. (1998) Diatary Salt Restriction and Reduction of Dialysate Sodium to Control Hypertension in Maintenance Haemodialysis Patients. Nephrology Dialysis Transplantation, 13, 552-553.
Rahman, M., Fu, P., Sehgal, A.R. and Smith, M.C. (2000) Interdialytic Weight Gain, Compliance with Dialysis Regimen, and Age Are Independent Predictors of Blood Pressure in Hemodialysis Patients. American Journal of Kidney Diseases, 35, 257-265.
Chazot, C., Charra, B., Laurent, G., Didier, C., Vo Van, C., Terrat, J.C., Calemard, E., Vanel, T. and Ruffet, M. (1995) Interdialysis Blood Pressure Control by Long Haemodialysis Sessions. Nephrology Dialysis Transplantation, 10, 831-837.
Goldsmith, D.J., Covic, A.C., Venning, M.C. and Ackrill, P. (1997) Ambulatory Blood Pressure Monitoring in Renal Dialysis and Transplant Patients. American Journal of Kidney Diseases, 29, 593-600.
Locatelli, F., Covic, A., Chazot, C., Leunissen, K., Luno, J. and Yaqoob, M. (2004) Optimal Composition of the Dialysate, with Emphasis on its Influence on blood Pressure. Nephrology Dialysis Transplantation, 19, 785-796.
Movilli, E., Camerini, C., Gaggia, P., Zubani, R., Feller, P., Poiatti, P., et al. (2013) Role of Dialysis Sodium Gradient on Intradialytic Hypertension: An Observational Study. American Journal of Nephrology, 38, 413-419.
Raimann, J.G. and Canaud, B. (2016) Association between Pre Hemodialysis Serum Sodium Concentration and Blood Pressure: Results from a Retrospective Analysis from the International Monitoring Dialysis Outcomes (MONDO) Initiative. Journal of Human Hypertension, 30, 442-448. https://doi.org/10.1038/jhh.2015.79