Photo Credit: Maria Symchych-Navrotska
The following is a summary of “Association of diabetes with changes in blood pressure during hemodialysis: A secondary analysis of the frequent hemodialysis network daily trial,” published in the May 2024 issue of Nephrology by Moloney et al.
Diabetes mellitus often leads to kidney failure and can complicate matters with autonomic neuropathy, affecting blood pressure (BP) regulation during hemodialysis (HD).
Researchers conducted a retrospective study investigating how diabetes influences intra-dialytic hypotension (IDH) and peri-dialytic blood pressure parameters.
They used data from the Frequent Hemodialysis Network (FHN) Daily Trial and employed random effects poisson and linear regression models to assess the association between diabetes and IDH risk and peri-dialytic BP measures. Associations were examined based on the frequency of HD treatments (6/week vs. 3/week) and pre-HD systolic BP levels.
The results showed 244 patients with intra-dialytic BP data; 100 (41%) had diabetes at the beginning of the study. The average age was 51 ± 14 years, with 39% female participants. Adjusted models showed that diabetes was linked to a 93% higher risk of IDH IRR 1.93; 95% CI 1.26, 2.95). Treatment frequency did not alter the diabetes-IDH connection significantly (P–interaction = 0.32). Still, stronger associations were found among those with higher pre-HD systolic BP (-4.2 mmHg) but not with pre or post-HD systolic BP.
Investigators concluded that participants with diabetes in the FHN Daily trial had higher chances of experiencing low BP during dialysis and lower minimum BP during dialysis compared to those without diabetes, regardless of receiving frequent dialysis sessions.
