Association of frequent intradialytic hypotension with the clinical outcomes of patients on hemodialysis: a prospective cohort study
Intradialytic hypotension (IDH) is a common complication of hemodialysis (HD), but there is no consensus on its definition. In 2015, Flythe proposed a definition of IDH (Definition 1 in this study): nadir systolic blood pressure (SBP) <90 mmHg during hemodialysis for patients with pre-dialysis SB...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2024-12-01
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| Series: | Renal Failure |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2023.2296612 |
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| _version_ | 1832591080144502784 |
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| author | Yuanhao Wu Jianda Lu Tingting Wang Xiaoye Zhu Jun Xue Li You |
| author_facet | Yuanhao Wu Jianda Lu Tingting Wang Xiaoye Zhu Jun Xue Li You |
| author_sort | Yuanhao Wu |
| collection | DOAJ |
| description | Intradialytic hypotension (IDH) is a common complication of hemodialysis (HD), but there is no consensus on its definition. In 2015, Flythe proposed a definition of IDH (Definition 1 in this study): nadir systolic blood pressure (SBP) <90 mmHg during hemodialysis for patients with pre-dialysis SBP <159 mmHg, and nadir SBP <100 mmHg during hemodialysis for patients with pre-dialysis SBP ≥160 mmHg. This prospective observational cohort study investigated the association of frequent IDH based on Definition 1 with clinical outcomes and compared Definition 1 with a commonly used definition (nadir SBP <90 mmHg during hemodialysis, Definition 2). The incidence of IDH was observed over a 3-month exposure assessment period. Patients with IDH events ≥30% were classified as ‘frequent IDH’; the others were ‘infrequent IDH’. All-cause mortality, cardiovascular mortality, and all-cause hospitalization events were followed up for 36 months. This study enrolled 163 HD patients. The incidence of IDH was 11.1% according to Definition 1 and 10.5% according to Definition 2. The Kaplan-Meier curves showed that frequent IDH patients had higher risks of all-cause mortality (p = 0.009, Definition 1; p = 0.002, Definition 2) and cardiovascular mortality (p = 0.021, Definition 1). Multivariable Cox regression analysis indicated that frequent IDH was independently associated with a higher risk of all-cause mortality (Model 1: HR = 2.553, 95%CI 1.334–4.886, p = 0.005; Model 2: HR = 2.406, 95%CI 1.253–4.621, p = 0.008). In conclusion, HD patients classified as frequent IDH are at a greater risk of all-cause mortality. This highlights the significance of acknowledging and proactively managing frequent IDH within the HD patients. |
| format | Article |
| id | doaj-art-1d4f5ab813bb424fa6b6f6869af2b82c |
| institution | Kabale University |
| issn | 0886-022X 1525-6049 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj-art-1d4f5ab813bb424fa6b6f6869af2b82c2025-01-23T04:17:47ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492024-12-0146110.1080/0886022X.2023.2296612Association of frequent intradialytic hypotension with the clinical outcomes of patients on hemodialysis: a prospective cohort studyYuanhao Wu0Jianda Lu1Tingting Wang2Xiaoye Zhu3Jun Xue4Li You5Department of Nephrology, Huashan Hospital Affiliated to Fudan University, Shanghai, ChinaDepartment of Nephrology, Huashan Hospital Affiliated to Fudan University, Shanghai, ChinaDepartment of Nephrology, Huashan Hospital Affiliated to Fudan University, Shanghai, ChinaDepartment of Nephrology, Huashan Hospital Affiliated to Fudan University, Shanghai, ChinaDepartment of Nephrology, Huashan Hospital Affiliated to Fudan University, Shanghai, ChinaDepartment of Nephrology, Huashan Hospital Affiliated to Fudan University, Shanghai, ChinaIntradialytic hypotension (IDH) is a common complication of hemodialysis (HD), but there is no consensus on its definition. In 2015, Flythe proposed a definition of IDH (Definition 1 in this study): nadir systolic blood pressure (SBP) <90 mmHg during hemodialysis for patients with pre-dialysis SBP <159 mmHg, and nadir SBP <100 mmHg during hemodialysis for patients with pre-dialysis SBP ≥160 mmHg. This prospective observational cohort study investigated the association of frequent IDH based on Definition 1 with clinical outcomes and compared Definition 1 with a commonly used definition (nadir SBP <90 mmHg during hemodialysis, Definition 2). The incidence of IDH was observed over a 3-month exposure assessment period. Patients with IDH events ≥30% were classified as ‘frequent IDH’; the others were ‘infrequent IDH’. All-cause mortality, cardiovascular mortality, and all-cause hospitalization events were followed up for 36 months. This study enrolled 163 HD patients. The incidence of IDH was 11.1% according to Definition 1 and 10.5% according to Definition 2. The Kaplan-Meier curves showed that frequent IDH patients had higher risks of all-cause mortality (p = 0.009, Definition 1; p = 0.002, Definition 2) and cardiovascular mortality (p = 0.021, Definition 1). Multivariable Cox regression analysis indicated that frequent IDH was independently associated with a higher risk of all-cause mortality (Model 1: HR = 2.553, 95%CI 1.334–4.886, p = 0.005; Model 2: HR = 2.406, 95%CI 1.253–4.621, p = 0.008). In conclusion, HD patients classified as frequent IDH are at a greater risk of all-cause mortality. This highlights the significance of acknowledging and proactively managing frequent IDH within the HD patients.https://www.tandfonline.com/doi/10.1080/0886022X.2023.2296612Intradialytic hypotensionhemodialysisall-cause mortalitycardiovascular mortalityall-cause hospitalization |
| spellingShingle | Yuanhao Wu Jianda Lu Tingting Wang Xiaoye Zhu Jun Xue Li You Association of frequent intradialytic hypotension with the clinical outcomes of patients on hemodialysis: a prospective cohort study Renal Failure Intradialytic hypotension hemodialysis all-cause mortality cardiovascular mortality all-cause hospitalization |
| title | Association of frequent intradialytic hypotension with the clinical outcomes of patients on hemodialysis: a prospective cohort study |
| title_full | Association of frequent intradialytic hypotension with the clinical outcomes of patients on hemodialysis: a prospective cohort study |
| title_fullStr | Association of frequent intradialytic hypotension with the clinical outcomes of patients on hemodialysis: a prospective cohort study |
| title_full_unstemmed | Association of frequent intradialytic hypotension with the clinical outcomes of patients on hemodialysis: a prospective cohort study |
| title_short | Association of frequent intradialytic hypotension with the clinical outcomes of patients on hemodialysis: a prospective cohort study |
| title_sort | association of frequent intradialytic hypotension with the clinical outcomes of patients on hemodialysis a prospective cohort study |
| topic | Intradialytic hypotension hemodialysis all-cause mortality cardiovascular mortality all-cause hospitalization |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2023.2296612 |
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