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Beta-blocker efficacy for intra- and interdialytic hypertension patients: a systematic review and meta-analysis

  • Nephrology - Review
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

A Nephrology – Letter to the Editor to this article was published on 07 May 2024

Abstract

Purpose

Intradialytic hypertension affects 5–15% of hemodialysis patients, yet relevant studies are relatively scarce. It is also associated with higher interdialytic blood pressure. Beta-blockers can be preferred as antihypertensive drugs due to their superior blood pressure control, decreased risk of cardiovascular events, improved endothelial cell function, and decreased noradrenaline levels. Through this study, beta-blocker antihypertensive effects in intra- and interdialytic hypertension were analyzed.

Methods

Systematic review and meta-analysis were performed following PRISMA guidelines. We registered our PROSPERO protocol (Registration ID: CRD42023446184) and included relevant full-text clinical trials or RCTs from 2008 to 2023 with predetermined keywords and criteria from multiple databases including PUBMED, COCHRANE, SCOPUS, and citation searching. Seven eligible articles were included in this review study.

Results

Four studies with 82 participants for intradialytic hypertension evaluation were included. Meta-analysis showed a decrease in SBP in intradialytic hypertensive patients after beta-blocker intervention, with a significant estimated mean difference of − 15.19 mmHg (P < 0.00001; 95% CI − 19.47 to − 10.91). Supporting previous data, SBP remains constant between pre- and post-dialysis with beta-blocker therapy, with an insignificant estimated mean difference of − 2.72 mmHg (P = 0.29; 95% CI − 7.80 to 2.36). Whereas five studies with 142 participants were included for interdialytic hypertension evaluation. Meta-analysis shows a significant decrease in SBP before to after therapy, with an estimated mean difference of − 10.92 (P < 0.0001; 95% CI − 16.33 to − 5.51).

Conclusion

Beta-blocker treatment resulted in significant reductions in post-hemodialysis systolic blood pressure among intra- and interdialytic hypertensive patients.

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Data availability

The data that support the findings of this study are available from corresponding author, with reasonable request. All data pertaining to this research are included in the supplementary section in this article.

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Funding

The authors conducted this review without any external funding or grants.

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Author notes

  1. Felicia Fransisca Saputra, Angeline Asti Shiela Permata and Jeanne Gabrielle Wibowo are contributing authors.

Authors and Affiliations

  1. Faculty of Medicine, University of Gadjah Mada, Yogyakarta, Indonesia

    Eugenia Maria Alodia Hartono

  2. Faculty of Medicine, University of Brawijaya, Malang, Indonesia

    Felicia Fransisca Saputra, Angeline Asti Shiela Permata & Jeanne Gabrielle Wibowo

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  1. Eugenia Maria Alodia Hartono
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  2. Felicia Fransisca Saputra
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Correspondence to Eugenia Maria Alodia Hartono.

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Hartono, E.M.A., Saputra, F.F., Permata, A.A.S. et al. Beta-blocker efficacy for intra- and interdialytic hypertension patients: a systematic review and meta-analysis. Int Urol Nephrol (2024). https://doi.org/10.1007/s11255-024-03973-2

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