Intradialytic Hypotension Hikes Long-Term Death Risk

The condition is independently associated with a 60% increased risk of 5-year mortality in maintenance hemodialysis patients.
The condition is independently associated with a 60% increased risk of 5-year mortality in maintenance hemodialysis patients.

SEATTLE—Intradialytic hypotension (IDH) independently predicts an increased long-term risk of death among patients on maintenance hemodialysis, researchers reported at the 2016 Annual Dialysis Conference.

In a study of 293 patients, Jin-bo Yu, MD, and colleagues at Fudan University in Shanghai, China, found that patients with IDH had a significant 1.6 times increased risk of 5-year mortality compared with those who did not have IDH in multivariable analysis. The study found that increasing left ventricular mass index also independently predicted an elevated risk of death.

Of the 293 patients, 117 (39.9%) experienced IDH, which the investigators defined as a sudden drop in systolic blood pressure of more than 20 mm Hg or in mean arterial pressure of more than 10 mm Hg. The researchers monitored intradialytic blood pressure over a 3-month period. During a 5-year follow-up, 84 patients died, for a mortality rate of 5.9% per year. The overall mortality rate rose as IDH incidence increased.

Risk factors for IDH included older age, high ultrafiltration rate, high levels of serum NT-proBNP and serum β2MG, and hypoalbuminemia, the investigators reported.

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