The following article features coverage from Kidney Week 2019. Click here to read more of Renal & Urology News’ conference coverage.

WASHINGTON—Intradialytic hypotension (IDH)—which may decrease systemic circulation to the lower extremities—is associated with an elevated risk of peripheral artery disease (PAD), investigators reported at the American Society of Nephrology’s 2019 Kidney Week conference.

“Our study suggests that patients with more frequent IDH may warrant a careful examination for PAD through a focused history and physical exam including foot checks, and other diagnostic testing as indicated,” lead investigator Tara I. Chang, MD, of Stanford University School of Medicine in Palo Alto, California, told Renal & Urology News.

In an analysis of data from the US Renal Data System, Dr Chang and her collaborators found that as the proportion of HD sessions with IDH increases, so does the risk of PAD. The presence of IDH in 1% to 14%, 15% to 29%, and 30% or more of HD sessions is significantly associated with a 6%, 16%, and 36% increased risk of PAD in adjusted analyses compared with the absence of IDH, according to the investigators. The investigators adjusted for baseline characteristics, comorbidities, laboratory values, and healthcare use.

The study examined data from 45,489 HD patients without preexisting PAD who initiated HD from 2006 to 2011. Dr Chang’s team defined IDH as nadir systolic blood pressure below 90 mm Hg. They assessed the proportion of HD sessions in which IDH occurred in 30-day intervals. The study’s primary outcome was incident PAD in the subsequent 30-day interval. Incident PAD developed in 8111 patients during 61,842 person-years of follow-up.

Read more of Renal & Urology News’ coverage of Kidney Week 2019 by visiting the conference page.

Reference

Seong EY, Liu S, Song SH, et al. Intradialytic hypotension and incident peripheral artery disease in patients with ESKD on hemodialysis. Presented in a November 7, 2019 oral session at the American Society of Nephrology’s annual Kidney Week conference in Washington, DC. Abstract TH-OR147.