Frequency of Intradialytic Hypotension in Hemodialysis Patients and Its Relationship with Serum Osmolarity and Electrolytes

Objective: Intradialytic hypotension (IDH) is the most common complication of hemodialysis (HD). Many factors (cardiac factors, lack of vasoconstriction, etc.) that cause IDH have been reported so far. However, studies investigating the relationship between IDH and serum osmolarity and serum electrolytes (especially magnesium) are not sufficient. In this study, we aimed to determine the incidence of IDH in hemodialysis patients and to investigate the relationship between serum osmolarity and electrolytes and IDH.Methods: A total of 94 patients received routine dialysis treatment at our center. Among these, 66 patients who met the inclusion criteria were included in the study. Serum osmolarity, electrolytes (sodium, potassium, calcium, magnesium), glucose and urea levels were measured from three samples drawn at the start, middle (2 hours in), and end of each session. Blood pressure was recorded every 15 minutes during HD with an ambulatory blood pressure device.Results: IDH was detected in 29 patients (44%). In patients with IDH, blood pressure and blood glucose levels at the beginning, middle, and end of sessions were higher than those without IDH. Magnesium levels were also higher in patients with IDH in samples obtained at the end of the sessions. Independent risk factors for IDH are stated as initial glucose level, magnesium level at the end of the session, and antihypertensive drug use.Discussion: It is important to control hypertension in patients with IDH and to prevent eating during HD sessions. Prospective studies on serum magnesium levels in the prevention of IDH are needed.