RELATIONSHIP BETWEEN SERUM MAGNESIUM LEVELS WITH INTRADIALYTIC HYPERTENSION IN REGULAR HEMODIALYSIS PATIENTS

Filsi Elsa Novenda; Alwi Thamrin Nasution; Syafrizal Nasution

Volume : VIII, Issue : IV, April - 2019

RELATIONSHIP BETWEEN SERUM MAGNESIUM LEVELS WITH INTRADIALYTIC HYPERTENSION IN REGULAR HEMODIALYSIS PATIENTS

Filsi Elsa Novenda, Alwi Thamrin Nasution, Syafrizal Nasution

Abstract :

Introduction: Intradialytic hypertension (IDH), one of cardiovascular complications of hemodialysis, is reported in around 5-15% of patients undergoing regular hemodialysis (HD). Etiology including subclinical fluid excess, sympathetic overactivity, activation of the angiotensin renin system, endothelial cell dysfunction, and specific dialytic techniques. Imbalances in endothelial derivative hormones, such as nitric oxide and endothelin-1, are also causes of IDH. One of the treatments proposed is by manipulating the composition of the dialysate, such as the concentration of magnesium (Mg). Mg dialysate concentration is known to affect intradialytic blood pressure by changing vascular tone so that it could change blood pressure. Method: This study was an analytical cross-sectional study to determine the relationship between magnesium levels and intradialytic hypertension in regular HD patients (≥ 3 months) aged> 18 years in the hemodialysis unit of General Hospital of Haji Adam Malik Medan. After obtaining approval from the ethics committee and giving informed consent, a magnesium level examination of the subject was conducted after hemodialysis process. Then pre-dialysis and durante dialysis blood pressure were measured. After the full data is collected, data processing and data analysis are conducted. Results: Of the 78 subjects, patients with intradialytic hypertension experienced hypomagnesemia of 63.3%, while patients with intradialytic hypotension experienced hypermagnesemia of 61.9%. Conclusion: There is a significant relationship between serum magnesium levels and intradialytic hypertension in regular hemodialysis patients (p = 0.001) with Mg levels as low as <1.6 mg / dl can affect intradialytic hypertension in regular hemodialysis patients (r=-0,502). Hypomagnesemia has a risk of 3.45 times greater of having intradialytic hypertension compared to a person with intradialytic hypotension or normotension during dialysis.