The Importance of Blood Pressure Control in End-Stage Renal Disease: A Case Report of Intracranial Hemorrhage

Hamid Faqih Umam (General Practitioner, Roemani Muhammadiyah Hospital, Semarang, Indonesia)
Nova Nasikhatussoraya (General Practitioner, Roemani Muhammadiyah Hospital, Semarang, Indonesia)
Shofa Chasani (Nephrology and Hypertension Consultant, Roemani Muhammadiyah Hospital, Semarang, Indonesia)
Durrotul Djannah (Neurologist, Roemani Muhammadiyah Hospital, Karanganyar, Indonesia)

Nusantara Science and Technology Proceedings
The 4th International Conference on Community Medicine and Medical Sciences

Introduction: End-Stage Renal Disease (ESRD) is a growing global health concern. ESRD often presents with high blood pressure that is unresponsive to medication. Long-standing high blood pressure is the primary cause of intracranial hemorrhage. It is more likely to occur in ESRD patients. Case Illustration: A 69-year-old woman was brought to the emergency room because of unconsciousness four hours earlier. She had a sudden severe headache before that. No history of trauma. Her consciousness was poor (GCS E1M2V1) and her blood pressure was high (213/78 mmHg) in the emergency unit. Head CT revealed intracerebral, intraventricular, and subarachnoid hemorrhages with a total volume of 81 cc and midline shift. The patient had been on dialysis twice a week for six years. She had uncontrolled hypertension said to routinely take antihypertensive drugs independently. Last year's dialysis visits showed high blood pressure, with a mean of 187/72 mmHg (224/112-166/51 mmHg). Given her complex condition, she underwent conservative therapy and died on the third day of treatment. Conclusion: ESRD patients are at high risk of intracranial hemorrhage. It is crucial to closely monitor blood pressure during dialysis visits. ESRD with intracranial hemorrhage has a poor prognosis, emphasizing the importance of preventive care.