Abstract: FR-PO779
Correlation of Intradialytic Blood Pressure Variability with Vascular Access Outcomes in Hemodialysis Patients
Session Information
- Hemodialysis: Vascular Access - II
November 03, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Dialysis
- 603 Hemodialysis: Vascular Access
Authors
- Seo, Hye mi, Jeju National University Hospital, Jeju City, Korea (the Republic of)
- Kim, Hyunwoo, Jeju National University Hospital, Jeju City, Korea (the Republic of)
- Kim, Ji young, Jeju National University Hospital, Jeju City, Korea (the Republic of)
- Kim, Miyeon, Jeju National University Hospital, Jeju City, Korea (the Republic of)
Background
Hemodialysis vascular access dysfunction is a major cause of morbidity and hospitalization in patients on hemodialysis. Identifying risk factors of vascular access failure is important because it will likely allow early intervention for dysfunctional hemodialysis fistulas. Recent studies has shown that blood pressure variability during dialysis are associated with increased cardiovascular morbidity and mortality. But there have been no studies related to effect of intradialytic BPV on vascular access outcomes. This study aimed to investigate the correlation of intradialytic BPV with vascular access outcomes in hemodialysis patients.
Methods
We examined 130 end stage renal disease patients with created vascular access between January 2009 and December 2016 in our hospital. Blood pressure data were collected three month after the start of hemodialysis for adaptation period. We examined 12 dialysis session per patient and recorded five times blood pressure for each session. Blood pressure variability (BPV) was assessed using the standard deviation of the residual derived from linear regression model. The primary outcome was primary vascular access patency defined as time to first intervention including angioplasty or surgical revision. Cox proportional hazards regression anlysis was used to access the risk of primary outcome (reintervention) or secondary ouctome (failure).
Results
Patients were followed up an average of 3.7 years. Patient’s mean age was 62 years. Among these, 64% of patients were male, 53% of patients had DM. We devided patients into two groups according to intradialytic blood pressure variability. The mean time to primary patency of high BPV group was 750 ± 131 days and low BPV group was 1613 ± 190 days. After adjustment for demographics, comorbidities and medications, high BPV was significantly associated with worse primary outcome ( HR, 2.30; 95% CI 1.39-3.82; p = 0.01) and worse secondary outcome. (HR,2.81; 95% CI 1.14-6.93; p = 0.025)
Conclusion
We observed a significant correlation between intradialytic BPV and vascular access patency. Lowering Intradialytic BPV is important to improve vascular access patency in hemodialysis patients.