Abstract: FR-PO571

Diabetes Mellitus versus Vascular Calcification: Impact on Predialytic Blood Pressure and Incidence of Intradialytic Hypotension

Session Information

Category: Hypertension

  • 1106 Hypertension: Clinical and Translational - Secondary Causes

Authors

  • Lee, Sinae, none, Anyang-si, Korea (the Republic of)
  • Lee, Seoung Woo, Inha University Hospital, Incheon, Korea (the Republic of)
Background

Diabetes mellitus (DM) and vascular calcification are highly prevalent in maintenance hemodialysis (HD) patients, but it has not known how they influence on pre-HD blood pressure (BP) and the incidence of intradialytic hypotension.

Methods

This study was performed from August 2010 to July 2014 in 66 patients who met the following criteria: HD duration for >6 months and HD 3 times weekly during the study. Four years of pre- and intradialytic BPs and laboratory data were collected. Abdominal aortic calcification (AAC) was assessed using the Kauppila score. Patients were classified as high (≥5) or low (<5) AAC. The KDOQI guideline was used to define IDH. IDH incidence was the number of sessions in which IDH occurred divided by the total number of monthly HD sessions. Subjects were classified into group 1 (high AAC, DM) (n=16), group 2 (high AAC, non-DM) (n=15), group 3 (low AAC, DM)(n=14), and group 4 (low AAC, non-DM) (n=21). Time series analysis (TSA) was performed to assess changes in pre-HD BP and the IDH incidence.

Results

Mean age was 61±11 years; 30 had DM; 50% were male; HD duration was 6.1±3.8 years; AAC score was 5.5±4.5; and HD sessions were 481±81. In TSA, pre-HD SBP, DBP, PP, and the IDH incidence were elevated by group in the order of 1>3>2>4, 4>2>3>1, 1>2=3>4, and 1>3>2=4, respectively (Fig. 1). Multiple regression showed that non-DM and low AAC was independently associated with pre-dialytic SBP (non-DM; β=-0.58, p<0.001; low AAC; β=-0.49, p=0.015), DBP (non-DM; β=0.34, p<0.001; low AAC; β=0.75, p<0.001), PP (non-DM; β=-0.57, p<0.001; low AAC; β= -0.69, p<0.001) and IDH incidence (non-DM; β=-0.31, p < 0.001; low AAC; β=-0.2, p=0.469).

Conclusion

Both DM and vascular calcification may influence pre-HD BPs and the IDH incidence; however, the effect of DM is more prominent.