Kidney Week

Abstract: SA-PO371

Impact of Intradialytic Hypotension Following Transition From Continuous Renal Replacement Therapy to Intermittent Hemodialysis on Mortality

Session Information

• Hemodialysis and Frequent Dialysis: CV and Risk Prediction
  November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Kim, Seong Geun, Seoul National University College of Medicine, Seoul, Korea (the Republic of)

Seong Geun Kim,

• Yun, Donghwan, Seoul National University College of Medicine, Seoul, Korea (the Republic of)

Donghwan Yun,

• Lee, Jinwoo, Seoul National University College of Medicine, Seoul, Korea (the Republic of)

Jinwoo Lee,

• Kim, Yong Chul, Seoul National University College of Medicine, Seoul, Korea (the Republic of)

Yong Chul Kim,

• Kim, Dong Ki, Seoul National University College of Medicine, Seoul, Korea (the Republic of)

Dong Ki Kim,

• Oh, Kook-Hwan, Seoul National University College of Medicine, Seoul, Korea (the Republic of)

Kook-Hwan Oh,

• Joo, Kwon Wook, Seoul National University College of Medicine, Seoul, Korea (the Republic of)

Kwon Wook Joo,

• Kim, Yon Su, Seoul National University College of Medicine, Seoul, Korea (the Republic of)

Yon Su Kim,

• Han, Seung Seok, Seoul National University College of Medicine, Seoul, Korea (the Republic of)

Seung Seok Han,

Background

Transition of dialysis modalities from continuous renal replacement therapy (CRRT) to intermittent hemodialysis (iHD) is frequently conducted during a recovery phase of critically ill patients with acute kidney injury. Herein, we addressed the occurrence of intradialytic hypotension (IDH) after transition, and its association with the risk of mortality.

Methods

A total of 541 patients with acute kidney injury who attempted transition from CRRT to iHD were retrospectively collected from 2010 to 2020 at Seoul National University Hospital, Korea. IDH was defined as a discontinuation of dialysis because of hemodynamic instability plus when nadir systolic blood pressure was less than 90 mmHg or a decrease in systolic blood pressure ≥20 mmHg occurred during the 1^st session of iHD. Odds ratios (ORs) of outcomes, such as in-hospital mortality and weaning from RRT, were measured using logistic regression model after adjusting multiple variables.

Results

IDH occurred in 197 (36%) patients, and their mortality rate (44%) was higher than 19% in those without IDH (OR, 2.64 [1.70–4.08). The iHD sessions with IDH delayed a successful weaning from RRT with a OR of 0.62 [0.43–0.90] compared with those without IDH. Factors, such as low blood pressure, high pulse rate, low urine output, use of mechanical ventilator and vasopressors, and hypoalbuminemia, were associated with the IDH risk.

Conclusion

The IDH occurrence following transition from CRRT to iHD is associated with high mortality and delayed weaning from RRT.