RESUMO: Estudo transversal, de caráter descritivo-exploratório. Objetivou analisar a presença de hipertensão arterial em pacientes portadores de doença renal crônica em tratamento hemodialítico e seus fatores associados. Foram entrevistados 140 pacientes de um instituto de nefrologia localizado no interior do estado de Minas Gerais, no período de agosto a outubro de 2013. A prevalência de hipertensão arterial nos pacientes portadores de doença renal crônica foi de 78,8%. Constatou-se relação entre diabetes mellitus, dislipidemias e desconhecimento acerca da insuficiência renal com a hipertensão arterial. Identificou-se que 72,2% dos participantes excederam ao peso ideal, e destes, 63,3% apresentaram crise hipertensiva no período interdialítico. Conclui-se que a hipertensão arterial está presente significativamente nos indivíduos e os fatores associados são: adesão efetiva ao tratamento dialítico e medicamentoso; controle de ingesta hídrica e alimentar; e atividade física. DESCRITORES:Enfermagem; Insuficiência renal crônica; Hipertensão. ARTERIAL HYPERTENSION IN PATIENTS RECEIVING HEMODIALYSIS TREATMENT AND ASSOCIATED FACTORSABSTRACT: This transversal study, with a descriptiveexploratory character, aimed to analyze the presence of arterial hypertension in patients with chronic kidney disease undergoing hemodialysis treatment, and its associated factors. Interviews were held with 140 patients of an institute of nephrology located in the rural area of the state of Minas Gerais, in August -October 2013. The prevalence of arterial hypertension in patients with chronic kidney disease was 78.8%. A relationship was observed between diabetes mellitus, dyslipidemias and ignorance regarding renal failure with arterial hypertension. It was identified that 72.2% of the participants were above their ideal weight, and that of these, 63.3% presented hypertensive crisis in the interdialytic period. It is concluded that arterial hypertension is significantly present in individuals, and that the associated factors are: effective adherence to the dialysis and drug treatment; control of fluid and food intake; and physical activity.
BackgroundArterial stiffness has been associated with renal dysfunction and its progression, but the pathophysiological relation underlying this association has not been fully established, particularly among individuals without hypertension and diabetes. We investigated the cross-sectional associations between arterial stiffness and renal function in adults without cardiovascular disease, and whether this association remained among subjects without hypertension and diabetes.MethodsAll eligible participants from ELSA-Brasil (2008–2010), aged 35 to 74 years (N = 13,586) were included, of whom 7,979 were free from hypertension and diabetes. The response variables were: 1) low glomerular filtration rate (eGFR<60ml/min/1.73m2) estimated by CKD-EPI; 2) increased albumin/creatinine ratio (ACR ≥30mg/g); and 3) chronic kidney disease (CKD). Arterial stiffness was ascertained by the carotid-femoral pulse wave velocity (PWV). The covariates were sex, age, race/color, level of schooling, smoking, body mass index, total cholesterol/HDL-c glycated hemoglobin, diabetes, systolic blood pressure, heart rate and use of antihypertensive drugs. Logistic regression was used to examine the associations.ResultsAfter all adjustments, 1 m/s increase in PWV was associated with ORs equal to 1.10 (95%CI: 1.04–1.16), 1.10 (95%CI: 1.05–1.16) and 1.12 (95%CI: 1.08–1.17) of low eGFR, high ACR, and CKD, respectively. In subjects without hypertension and diabetes, these ORs were 1.19 (95%CI: 1.07–1.33), 1.20 (95%CI: 1.07–1.32) and 1.21 (95%CI: 1.11–1.30), respectively.ConclusionThe increase in PWV was associated with all renal dysfunction markers, even in individuals without hypertension and diabetes, suggesting a relation that is not completely mediated by the presence of these conditions.
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