Author(s): Darimireddi Siva Kumar1, Salla Surya Prakasa Rao2, Bayya Aswin Bharatji Babu3, Gedda Jyothsna Pavani4
To study the incidence of acute cardiovascular complications during haemodialysis in patients with chronic kidney disease with end-stage renal failure on maintenance haemodialysis.
Patients with chronic kidney disease with end-stage renal failure on maintenance haemodialysis at King George Hospital, Andhra Medical College, Visakhapatnam, India, were studied during the period of June 2015 to August 2016. In our study, all the 100 patients underwent 8510 haemodialysis sessions during 1-year period of study.
Cardiovascular complications are the most common intradialytic complications occurred during the study. Hypotension is the commonest of all the intradialytic as well as cardiovascular complications with a frequency of 1278, which account for 15.01% of the haemodialysis sessions. This was followed by 879 episodes of hypertension (10.32%), 190 episodes of cardiac arrhythmias (2.23%), which include complex ventricular arrhythmias and supraventricular arrhythmias and 162 episodes of chest pain (1.90%). Of the 100 patients, 37% of patients developed cardiac arrhythmias during haemodialysis. The frequency of arrhythmic episodes was 190 (2.23%). Among these, Supraventricular Arrhythmias (SVA) and Complex Ventricular Arrhythmic (CVA) episodes account for 159 (83.68%) and 31 (16.31%), respectively. CVA and SVA occurred in 29% and 19% of patients in the study group, respectively. Both CVA and SVA occurred in 12% of patients.
Intradialytic hypotension is the most common acute intradialytic complication in patients with chronic kidney disease with end-stage renal failure undergoing maintenance haemodialysis. This is followed by intradialytic hypertension. Sudden cardiac arrest is the most common cause of death during haemodialysis in patients with end-stage renal disease on haemodialysis. Mortality is high in patients with end-stage renal failure in maintenance haemodialysis with ischaemic heart disease.