Association between Hyperparathyrodism and Intradialytic Hypertension in Prevalent Hemodialysis Patients

Abstract

Abstract Background Intradialytic hypertension is a recognized short-term risk marker associated with increased 30-day morbidity and mortality in end-stage kidney disease (ESKD) patients undergoing hemodialysis. Biomarker dynamics, reflecting changes over time, have gained importance in predicting clinical outcomes. This study investigated the relationship between hyperparathyroidism and intradialytic hypertension in prevalent hemodialysis patients, focusing on dynamic changes in intact parathyroid hormone (iPTH) levels. Aim of the Work This study aimed to investigate the association between hyperparathyrodism and intradialytic hypertension in prevalent hemodialysis patients. Patients and Methods A cross-sectional study was conducted at El Dakahlia Governorate Hospital, involving 70 ESKD patients on regular hemodialysis. Patient demographics, comorbidities, medication use, and dialysis-related parameters were recorded. Blood pressure, body mass index (BMI), and laboratory results, including iPTH, were measured pre- and post-dialysis. Results The mean age of the study cohort was 41.24 years, with 54.3% males. Half of the patients were on beta-blockers, 40% on ACE inhibitors/ARBs, and calcium channel blockers, reflecting the prevalence of comorbid hypertension. Patients with intradialytic hypertension (14.3%) exhibited significantly higher post-dialytic BMI and systolic blood pressure (p < 0.001), while diastolic blood pressure decreased post-dialysis (p < 0.001). No significant differences were observed in age, gender, smoking, comorbidities, or antihypertensive drug usage between patients with and without intradialytic hypertension. Conclusion From this study we found that the prevalence of iHTN was (14.3%). Intradialytic hypertension was significantly associated with metabolic disorders including anemia, low iPTH level. There were significant indirect moderate correlations between iPTH and SBP pre, intra and postdialytic. There was significant indirect moderate correlation between iPTH and serum creatinine. Also, there were significant indirect weak correlations between iPTH with serum BUN, serum potassium and serum phosphorus.