Abstract: TH-PO281
Intradialytic Hypotension and Worse Outcome in Patients with AKI Requiring Intermittent Hemodialysis
Session Information
- Hemodialysis: Volume, Metabolic Complications, Clinical Outcomes
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Park, Yeongwon, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
- Park, Sehoon, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
- Kim, Seong Geun, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
- Han, Seung Seok, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
Background
Intradialytic hypotension (IDH) is a critical complication related with worse outcomes in patients undergoing maintenance hemodialysis. Herein, we addressed impact of IDH on death and other outcomes in patients with severe acute kidney injury (AKI) requiring intermittent hemodialysis.
Methods
We retrospectively reviewed 1,009 patients who underwent intermittent hemodialysis due to severe AKI. IDH was defined as a decrease in systolic blood pressure (SBP) of ≥30 mmHg, with or without a nadir SBP of <90 mmHg during the first session. The primary outcome was all-cause death, and transfer to the intensive care unit due to unstable status was additionally analyzed. Hazard ratios (HRs) of outcomes were calculated using a Cox regression model after adjusting for multiple variables. Risk factor of IDH was evaluated using a logistic regression model.
Results
IDH occurred in 449 (44%) patients during the first hemodialysis session. Patients with IDH had higher death rate (39.6%) than those without IDH (23%) (HR, 1.39 [1.09–1.78]). The rate of ICU transfer was higher in patients experiencing IDH (17%) than those without IDH (11%) (HR 1.46 [1.02–2.09]). Factors, such as old age, high SBP, high pulse rate, active cancer, cirrhosis, anemia, and hypoalbuminemia, were associated with an increased risk of IDH episode.
Conclusion
The occurrence of IDH is associated with worse outcomes in patients with AKI requiring intermittent hemodialysis. Therefore, careful monitoring of IDH is necessary in this patient subset.