Jinbo Yu1,2,3, Zhonghua Liu1,2,3, Bo Shen1,2,3, Jie Teng1,2,3, Jianzhou Zou1,2,3, Xiaoqiang Ding1,2,3. 1. Division of Nephrology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai, China. 2. Shanghai Institute of Kidney Disease and Dialysis, Shanghai, China. 3. Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.
Abstract
AIMS: This study aimed to assess risk factors of intradialytic hypotension (IDH) and the association of prognosis and IDH among maintenance hemodialysis (MHD) patients. METHODS: Among 293 patients, 117 were identified with IDH (more than 4 hypotensive events during 3 months). The association between IDH and survival was evaluated. RESULTS: The incidence of IDH was 39.9%. Age, ultrafiltration rate, N-terminal pro-B-type natriuretic peptide (NT-proBNP), albumin, β2-microglobulin (β2MG), and aortic root inside diameter (AoRD) were independently associated with IDH. During the 5-year follow-up, 84 patients died with a mortality rate 5.2 per 100 person-year. IDH-prone patients had a higher all-cause mortality rate. IDH and left ventricular mass index were independent risk factors for death (HR 1.655, 95% CI 1.061-2.580; HR 1.008, 95% CI 1.001-1.016). CONCLUSION: IDH is an independent risk factor for long-term mortality in MHD patients. Patients with older age, high ultrafiltration rate, high level of serum NT-proBNP and β2MG, hypoalbuminemia, and shorter AoRD are at high risk of IDH.
AIMS: This study aimed to assess risk factors of intradialytic hypotension (IDH) and the association of prognosis and IDH among maintenance hemodialysis (MHD) patients. METHODS: Among 293 patients, 117 were identified with IDH (more than 4 hypotensive events during 3 months). The association between IDH and survival was evaluated. RESULTS: The incidence of IDH was 39.9%. Age, ultrafiltration rate, N-terminal pro-B-type natriuretic peptide (NT-proBNP), albumin, β2-microglobulin (β2MG), and aortic root inside diameter (AoRD) were independently associated with IDH. During the 5-year follow-up, 84 patients died with a mortality rate 5.2 per 100 person-year. IDH-prone patients had a higher all-cause mortality rate. IDH and left ventricular mass index were independent risk factors for death (HR 1.655, 95% CI 1.061-2.580; HR 1.008, 95% CI 1.001-1.016). CONCLUSION: IDH is an independent risk factor for long-term mortality in MHD patients. Patients with older age, high ultrafiltration rate, high level of serum NT-proBNP and β2MG, hypoalbuminemia, and shorter AoRD are at high risk of IDH.
Authors: Johanna Kuipers; Loes M Verboom; Karin J R Ipema; Wolter Paans; Wim P Krijnen; Carlo A J M Gaillard; Ralf Westerhuis; Casper F M Franssen Journal: Am J Nephrol Date: 2019-05-24 Impact factor: 3.754
Authors: Adrianna Douvris; Khalid Zeid; Swapnil Hiremath; Sean M Bagshaw; Ron Wald; William Beaubien-Souligny; Jennifer Kong; Claudio Ronco; Edward G Clark Journal: Intensive Care Med Date: 2019-08-12 Impact factor: 17.440