{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T13:15:35Z","timestamp":1783430135785,"version":"3.54.6"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nephrol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Intradialytic blood pressure (BP) instability\u2014manifesting as intradialytic hypotension (IDH) or hypertension (IDHT)\u2014is increasingly recognized as a contributor to cardiovascular morbidity in hemodialysis patients. Despite its clinical significance, data on intradialytic BP behavior from sub-Saharan Africa remain scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the prevalence and clinical factors associated with intradialytic BP changes among chronic kidney disease (CKD) patients on maintenance hemodialysis in a tertiary hospital in Somalia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective observational study of adult patients undergoing maintenance hemodialysis at Mogadishu Somali Turkish Training and Research Hospital between June and September 2022. Intradialytic hypotension was defined as a \u226520 mmHg drop in systolic BP and\/or \u226510 mmHg drop in mean arterial pressure (MAP), while IDHT was defined as a &amp;gt;10 mmHg increase in systolic BP and\/or \u226515 mmHg increase in MAP from pre- to post-dialysis. Demographic, clinical, dialysis, and laboratory variables were extracted. Logistic regression models were used to evaluate factors associated with IDH and IDHT, with reduced modeling for IDHT because of the small number of events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 149 patients (mean age 51.1 \u00b1 16.4 years; 57.7% female), the prevalence of IDH and IDHT was 55.0% and 12.1%, respectively. Most patients (74.5%) had hypertension and 96.5% used an arteriovenous fistula. In multivariable analysis, higher pre-dialysis systolic BP (OR 1.037; 95% CI 1.018\u20131.056) and ultrafiltration goal (OR 1.537; 95% CI 1.002\u20132.357) were associated with IDH. Because pre-dialysis systolic BP contributed to the outcome definition, this association should be interpreted cautiously. In the reduced IDHT model, ultrafiltration goal was inversely associated with IDHT (OR 0.543; 95% CI 0.298\u20130.990), while antihypertensive medication burden was not statistically significant. Exploratory electrolyte tertile analysis showed a higher proportion of IDH among patients in lower calcium and higher phosphate tertiles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Intradialytic BP instability was common among hemodialysis patients in Somalia, particularly IDH. Given the retrospective design, reliance on pre- and post-dialysis BP measurements, and limited number of IDHT events, the findings should be interpreted as associative and hypothesis-generating. Routine BP monitoring and further prospective studies are warranted to better characterize hemodynamic instability in resource-constrained dialysis settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneph.2026.1822440","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T06:12:00Z","timestamp":1782195120000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Intradialytic blood pressure instability and associated factors among hemodialysis patients in Somalia: a retrospective study"],"prefix":"10.3389","volume":"6","author":[{"given":"Abdulrashid","family":"Hashi Mohamed","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Mogadishu Somali Turkish Training and Research Hospital","place":["Mogadishu, Somalia"]},{"name":"Faculty of Medicine and Surgery, Al Hayat Medical University","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamud","family":"Mire Waberi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Mogadishu Somali Turkish Training and Research Hospital","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feyza","family":"AKSU","sequence":"additional","affiliation":[{"name":"Department of Cardiology at G\u00f6ztepe Prof. Dr. S\u00fcleyman Yal\u00e7\u0131n City Hospital","place":["Istanbul, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nurto Abdulkadir","family":"Said","sequence":"additional","affiliation":[{"name":"Department of Public Health, Mogadishu University","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Said","family":"Abdirahman Ahmed","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Mogadishu Somali Turkish Training and Research 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