Intradialytic Hypertension: Epidemiology and Pathophysiology of a Silent Killer

Overview

Journal Hypertens Res

Specialty Cardiology & Vascular Diseases

Date 2022 Aug 18

PMID 35982265

Authors

Fotini Iatridi

Marieta P Theodorakopoulou

Aikaterini Papagianni

Pantelis Sarafidis

Affiliations

Soon will be listed here.

Abstract

The term intradialytic hypertension (IDH) describes a paradoxical rise in blood pressure (BP) during or immediately after the hemodialysis session. Although it was formerly considered a phenomenon without clinical implications, current evidence suggests that IDH may affect up to 15% of hemodialysis patients and exhibit independent associations with future cardiovascular events and all-cause mortality. Furthermore, during the last decade, several studies have tried to elucidate the complex pathophysiological mechanisms responsible for this phenomenon. Volume overload, intradialytic sodium gain, overactivity of the sympathetic-nervous-system and renin-angiotensin-aldosterone system, endothelial dysfunction and dialysis-related electrolyte disturbances have been proposed to be involved in the pathogenesis of the BP increase during hemodialysis. This review attempts to summarize existing evidence on the epidemiology, pathophysiology and clinical characteristics of the distinct phenomenon of IDH.

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