الفهرس 
9Chronic Kidney DiseaseOnly 14 pages are availabe for public view
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Abstract
Hypertension is a major risk factor for cardiovascular and renal disease. Conversely, chronic kidney disease (CKD) is the most common form of secondary hypertension and mounting evidence suggests it is an independent risk factor for cardiovascular morbidity and mortality. The blood pressure variability and extreme changes of the volemic state make it difficult to obtain a truly representative value of blood pressure in hemodialysis patients if based only on an isolated blood pressure measurements in dialysis center. Intradialytic hypertension (IDH) occurs in around 10% of hemodialysis (HD) patients. It is associated with HD patients’ hospitalization and increased risk of death. There is no uniform definition of IDH, it can be defined as a sustained increase of blood pressure (BP) during the dialysis session with BP values during and at the end of the dialysis session exceeding BP values at dialysis onset. Etiology of dialysis induced hypotension and hypertension remains speculative. There is mounting evidence that endothelin ET-1 may play a vital role in these hemodynamic changes. To evaluate the role of endothelin-1 in hypertension in ESRD and relation of changes in endothelin-1 level during dialysis with intradialytic hypertension. group I: (24) ESRD patient on regular hemodialysis, with intradialytic hypertension (an increase in mean arterial blood pressure (MAP) ≥ 15 mmHg during or immediately after hemodialysis). group II included (24) ESRD patients on regular hemodialysis with well controlled blood pressure. In this study we observed that basal Endothelin-1 level had a significant moderate diagnostic performance in prediction of intradialysis HTN. Study group patients had lower dry weight (p value 0.006) significantly higher UF volume (p value 0.025), higher pre dialysis k level (p value 0.009) and a higher endothelin-1 level (p value <0.001). There was significant positive correlation between basal Endothelin-1 and DBP after dialysis.