Relationship Between Volume Status and Blood Pressure in Children with End Stage Renal Disease on Chronic Hemodialysis

The aim of present study was to determine the effect of interdialytic fluid accumulation (or intradialytic fluid removal) on blood pressure in pediatric patients with End Stage Renal Disease (ESRD) on chronic hemodialysis. Fifty patients with end stage renal disease on maintenance hemodialysis were enrolled in the study. They included 32 males and 18 females; age ranged from 2-16 years. We determined the association of the intradialytic decrease in blood pressure with the intradialytic decrease in plasma volume and body weight. The intradialytic decrease in plasma volume was calculated by measuring the pre- and postdialysis plasma proteins using the following equation: ΔPV = (PVpre-PVpost)/PVpre = (TPpost-TPpre)/TPpost. We found a significant positive correlation between both intradialytic decrease in systolic, diastolic and mean blood pressures and predialysis systolic, diastolic and mean blood pressures versus the decrease in plasma volume and body weight. Also, the highest decrease in plasma volume and body weight was found in the first session of the week (longest interdialytic period) compared to the 2nd and 3rd sessions of the week. Volume status influences both predialysis and postdialysis blood pressure. The effect of volume status on blood pressure may be higher in pediatric population than adults.