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Kidney Week

Abstract: TH-PO281

Intradialytic Hypotension and Worse Outcome in Patients with AKI Requiring Intermittent Hemodialysis

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Park, Yeongwon, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
  • Park, Sehoon, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
  • Kim, Seong Geun, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
  • Han, Seung Seok, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
Background

Intradialytic hypotension (IDH) is a critical complication related with worse outcomes in patients undergoing maintenance hemodialysis. Herein, we addressed impact of IDH on death and other outcomes in patients with severe acute kidney injury (AKI) requiring intermittent hemodialysis.

Methods

We retrospectively reviewed 1,009 patients who underwent intermittent hemodialysis due to severe AKI. IDH was defined as a decrease in systolic blood pressure (SBP) of ≥30 mmHg, with or without a nadir SBP of <90 mmHg during the first session. The primary outcome was all-cause death, and transfer to the intensive care unit due to unstable status was additionally analyzed. Hazard ratios (HRs) of outcomes were calculated using a Cox regression model after adjusting for multiple variables. Risk factor of IDH was evaluated using a logistic regression model.

Results

IDH occurred in 449 (44%) patients during the first hemodialysis session. Patients with IDH had higher death rate (39.6%) than those without IDH (23%) (HR, 1.39 [1.09–1.78]). The rate of ICU transfer was higher in patients experiencing IDH (17%) than those without IDH (11%) (HR 1.46 [1.02–2.09]). Factors, such as old age, high SBP, high pulse rate, active cancer, cirrhosis, anemia, and hypoalbuminemia, were associated with an increased risk of IDH episode.

Conclusion

The occurrence of IDH is associated with worse outcomes in patients with AKI requiring intermittent hemodialysis. Therefore, careful monitoring of IDH is necessary in this patient subset.