ASSOCIATION OF BODY MASS INDEX WITH HYPERTENSION AND DEMOGRAPHIC CHARACTERISTICS IN PATIENTS WITH END-STAGE RENAL DISEASE UNDERGOING MAINTENANCE HAEMODIALYSIS: A CROSS-SECTIONAL STUDY
DOI:
https://doi.org/10.69656/pjp.v22i3.1957Keywords:
Body mass index, End-stage renal disease, Hypertension, Maintenance haemodialysisAbstract
Background: End-stage renal disease (ESRD) is associated with a high burden of cardiovascular complications, particularly hypertension. Although body mass index (BMI) is an established indicator of nutritional status and cardiovascular risk, its association with hypertension among patients with ESRD undergoing maintenance haemodialysis remains inadequately studied in Pakistan. This study was conducted to determine the association of BMI with hypertension and demographic characteristics in patients with end-stage renal disease undergoing maintenance haemodialysis. Methods: This observational cross-sectional study was conducted in the Department of Nephrology, Holy Family Hospital, Rawalpindi, from Dec 2022 to Jun 2023 after ethical approval from CPSP. A total of 196 patients aged 18–75 years with ESRD undergoing maintenance haemodialysis for at least three months were recruited through non-probability consecutive sampling. Demographic characteristics, duration of ESRD, duration of haemodialysis, BMI, and blood pressure were recorded. Data were analysed using SPSS-25, and p≤0.05 was considered statistically significant. Results: Hypertensive patients had a higher mean age than non-hypertensive patients (51.2±11.4 vs 43.5±10.7 years). Males constituted 65.1% of hypertensive patients, while females were 34.9%. Underweight patients had a higher prevalence of hypertension than overweight patients. Mean systolic blood pressure was highest (166±13 mmHg) in underweight patients and lowest (139±7 mmHg) in obese patients. Conclusion: Body mass index was significantly associated with hypertension and haemodynamic parameters in patients with ESRD undergoing maintenance haemodialysis. Higher BMI was associated with relatively favourable cardiovascular profiles.
Pak J Physiol 2026;22(3):129–33, DOI: https://doi.org/10.69656/pjp.v22i3.1957
Downloads
References
Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int 2024;105(4 Suppl):S117–314.
Vaidya SR, Aeddula NR. Chronic Kidney Disease. [Updated 2024 Jul 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026. Available from: https://www.ncbi.nlm.nih.gov/ books/NBK535404/
Rout P, Aslam A. End-Stage Renal Disease. 2025. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026.
Francis A, Harhay MN, Ong ACM, Tummalapalli SL, Ortiz A, Fogo AB, et al. Chronic kidney disease and the global public health agenda: an international consensus. Nat Rev Nephrol 2024;20(7):473–85.
Mayeda L, Bansal N. Hypertension in patients with end-stage kidney disease requiring dialysis: bridging the divide between evidence and practice. Hypertension 2026;83(3):e234344.
Iqbal AM, Jamal SF. Essential Hypertension. [Updated 2023 Jul 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026. Available from: https://www.ncbi.nlm.nih.gov/ books/NBK539859/
Ameer OZ. Hypertension in chronic kidney disease: what lies behind the scene. Front Pharmacol 2022;13:949260. doi:10.3389/fphar.2022.949260.
Zhang Z, Wang Y. Management of cardiovascular diseases in chronic hemodialysis patients. Rev Cardiovasc Med 2023;24(7):185.
Zierle-Ghosh A, Jan A. Physiology, Body Mass Index. [Updated 2023 Nov 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535456/
Powell-Wiley TM, Poirier P, Burke LE, Després JP, Gordon-Larsen P, Lavie CJ, et al. Obesity and cardiovascular disease: a scientific statement from the American Heart Association. Circulation 2021;143(21):e984–1010.
Motofelea AC, Pecingina R, Olariu N, Marc L, Chisavu L, Bob F, et al. The obesity paradox reconsidered: evidence from a multicenter Romanian hemodialysis cohort. J Clin Med 2026;15(1):357.
Tsikliras N, Georgianos PI, Vaios V, Minasidis E, Anagnostara A, Chatzidimitriou C, et al. Prevalence and control of hypertension among patients on haemodialysis. Eur J Clin Invest 2020;50(10):e13292.
Herzog MJ, Müller P, Lechner K, Stiebler M, Arndt P, Kunz M, et al. Arterial stiffness and vascular aging: mechanisms, prevention, and therapy. Signal Transduct Target Ther 2025;10(1):282.
Bae EH, Lim SY, Kim B, Oh TR, Song SH, Suh SH, et al. Effects of blood pressure according to age on end-stage renal disease development in patients with diabetes: a nationwide population-based cohort study. Hypertension 2022;79:1765–76.
Mohamud FY, Adan FN, Jeele MOO, Ahmed MAM. Major cardiovascular events and associated factors among routine hemodialysis patients with end-stage renal disease at a tertiary care hospital in Somalia. Front Med (Lausanne) 2023;10:1086359.
Goorani S, Zangene S, Imig JD. Hypertension: a continuing public healthcare issue. Int J Mol Sci 2025;26(1):123.
Mustafa A, Yermekbay A, Zhankorazova A, Toktarbay B, Khamitova Z, Jumadilova D, et al. Hemodynamic effects of hemodialysis: the interaction between the heart and the arteries. J Nephrol 2025;38(9):2503–16.
Palamar M, Grosu Radulescu ID, Tanasescu MD, Sircuta A, Bob F. Vascular calcification in chronic kidney disease and hemodialysis: pathophysiological mechanisms and emerging biomarkers. Medicina (Kaunas) 2025;61(12):2169.
Motofelea AC, Olariu N, Pecingina R, Marc L, Chisavu L, Bob F, et al. BMI category and survival in incident hemodialysis patients: the overweight advantage in an Eastern European cohort. J Clin Med 2026;15(8):2856.
Kwon H, Yun JM, Park JH, Cho BL, Han K, Joh HK, et al. Incidence of cardiovascular disease and mortality in underweight individuals. J Cachexia Sarcopenia Muscle 2021;12(2):331–8.
Muthukrishnan S, Vashishta S, Bhat S. The impact of overweight-obesity on heart rate variability among Indian adults: a cross-sectional study. J Fam Med Prim Care 2025;14:1952–7.
Kang D, Youn S, Min JW, Ko EJ. Nutritional status evaluation and intervention in chronic kidney disease patients: practical approach. Nutrients 2025;17(20):3264.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Tehreem Arif, Amna Mahmood, Ayesha Tariq, Iffat Mushtaq, Sadia Javaid , Muhammad Asif Ammar, Urfa Zaryab Mir

This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
The author(s) retain the copyrights and allow their publication in Pakistan Journal of Physiology/Pak J Physiol/PJP to be FREE for research and academic purposes. It can be downloaded and stored, printed, presented, projected, cited and quoted with full reference of, and acknowledgement to the author(s) and the PJP. The contents are published with CC BY-ND 4.0 International License.








