Intradialytic blood pressure variability: prevalence, predictors, and consequences among hemodialysis patients and its relationship with sleep disorders

Abstract Background Chronic kidney disease (CKD) and end-stage renal disease (ESRD) pose significant health challenges worldwide, particularly in regions with limited access to advanced medical care. Dialysis, including hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD), remains essential in managing ESRD due to donor organ shortage. Understanding intradialytic blood pressure disorders is crucial for improving outcomes in HD patients. Methods This cross-sectional study investigated the prevalence, predictors, and consequences of intradialytic blood pressure disorders among HD patients in Shiraz, Iran. Data were collected from 104 HD patients aged 18–75 years, with assessments including blood pressure measurements, laboratory data, dialysis settings, and other related parameters. Results Significant blood pressure variability (BPV) during dialysis was observed in 59.6% of patients, with factors such as higher ultrafiltration amounts ( p < 0.022), elevated plasma potassium levels ( p < 0.018), and sleep disorders ( p < 0.008) significantly associated with BPV. Intradialytic hypertension was linked to lower platelet counts ( p < 0.001) and sleep disorders ( p = 0.226), while intradialytic hypotension was associated with various factors including sleep medication use ( p < 0.028), plasma potassium levels ( p < 0.024), and gender ( p = 0.021). Conclusions Blood pressure variability during hemodialysis is common among HD patients, with factors such as ultrafiltration amounts, plasma potassium levels, and sleep disorders (as a novel factor) significantly influencing intradialytic blood pressure fluctuations. These findings underscore the complexity of managing blood pressure in HD patients and highlight the need for comprehensive assessment and tailored interventions to optimize patient care.