Kidney Week

Abstract: SA-PO887

Time-Specific Effects of Patient Factors on Intradialytic Systolic Blood Pressure Changes in Patients Receiving Maintenance Hemodialysis

Session Information

• Dialysis: Cardiovascular, BP, Volume
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Lee, Sinae, Incheon Medical Center, Incheon, Korea (the Republic of)

Sinae Lee,

• Lee, Seoung Woo, Inha University Hospital, Inchon City, Korea (the Republic of)

Seoung Woo Lee,

Background

Intradialytic systolic blood pressure (SBP) changes are affected by patient factors. However, the specific time point at which these factors predominantly affect blood pressure during a hemodialysis (HD) session is unknown.

Methods

Laboratory and HD data from previous 1 year were collected for 97 patients who were receiving maintenance HD. The subjects were classified into 2 groups according to diabetes mellitus (DM) status, abdominal aortic calcification (AAC) score, and the median values of serum hemoglobin (Hb), sodium (Na), albumin (Alb), and osmolality (Osm): DM vs. non-DM, high AAC (≥8) vs. low AAC (<8), Hb1 (≥10.17 g/dL) vs. Hb2(<10.17 g/dL), Na1(≥136.5 mEq/L) vs. Na2(<136.5 mEq/L), Alb1(≥3.93 g/dL) vs. Alb2(<3.93 g/dL), Osm1(≥312 mOsm/kg) vs. Osm2(<312 mOsm/kg). SBP measurements were standardized as SBP at 0 (SBP0), 1 (SBP1), 2 (SBP2), 3 (SBP3), and 4 (SBP4) hours. Intradialytic SBP changes were assessed on the basis of hourly SBP changes (ΔSBP₁: SBP0-SBP1, ΔSBP₂: SBP1-SBP2, ΔSBP₃: SBP2-SBP3, ΔSBP₄: SBP3-SBP4). Linear mixed regression analysis was used to identify patient factors associated with ΔSBP₁, ΔSBP₂, ΔSBP₃, and ΔSBP₄, respectively.

Results

The subject characteristics were as follows: number of females, 45; number of subjects with DM, 49; mean age, 59±15 years; HD duration, 69±64 months; AAC score, 8.0±7.7 (median, 6.0); and number of subjects with high AAC (≥8), 42. ΔSBP₁ was negatively associated with non-DM status (vs. DM) (β= -7.71, p=0.04), and positively associated with mean Hb level (β= 4.93, p=0.009). ΔSBP₂ was positively associated with high AAC (β= 5.22, p=0.001). ΔSBP₃ was positively associated with high AAC (β= 2.34, p=0.021), and negatively associated with mean albumin level (β= -4.19, p=0.044). ΔSBP₄ was positively associated with high AAC (β= 2.66, p=0.054), and negatively associated with mean Hb level (β= -2.90, p=0.008).

Conclusion

The effects of patient factors on intradialytic SBP changes during an HD session predominated at different time points and differed at an individual level.