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Kidney Week

Abstract: TH-PO300

Hypotension at the Start of Dialysis Is a Risk Factor of Cardiovascular Mortality

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Suzuki, Shota, Yokohama Shiritsu Daigaku Fuzoku Shimin Sogo Iryo Center, Yokohama, Kanagawa, Japan
  • Fujiwara, Akira, Yokohama Shiritsu Daigaku Fuzoku Shimin Sogo Iryo Center, Yokohama, Kanagawa, Japan
  • Kawano, Rina, Yokohama Shiritsu Daigaku Fuzoku Shimin Sogo Iryo Center, Yokohama, Kanagawa, Japan
  • Haruna, Aiko, Yokohama Shiritsu Daigaku Fuzoku Shimin Sogo Iryo Center, Yokohama, Kanagawa, Japan
  • Haze, Tatsuya, Yokohama Shiritsu Daigaku Fuzoku Shimin Sogo Iryo Center, Yokohama, Kanagawa, Japan
  • Hirawa, Nobuhito, Yokohama Shiritsu Daigaku Fuzoku Shimin Sogo Iryo Center, Yokohama, Kanagawa, Japan
Background

In recent studies on hemodialysis (HD) patients, The association of Blood pressure at the start of dialysis
and cardiovascular disease (CVD) morbidity is controversial. In a retrospective study, we aimed to investigate whether the pre-hemodialysis blood pressure levels predict CVD-related death.

Methods

The patients were followed up for up to 4 years. At baseline, demographic data, comorbidity data, physical examination results, and laboratory data were recorded for each patient. Pre-dialysis fasting blood samples were collected from arterial blood lines at the beginning of a week. We divided the study patients into 4 groups according to their systolic blood pressure at the start of dialysis in an ascending order: from the bottom 25th percentile (Q 1 ) to the top 25th percentile (Q 4 ).The Cox proportional hazards model was used to assess the association between blood pressure and the risk of CVD related death.

Results

A total of 132 outpatients treated at the Kohsaikai Kamioooka Jinsei Clinic in Yokohama and the Soubudai Nieren Clinic in Kanagawa, Japan between December 2008 and July 2009 were enrolled. At the baseline, blood pressure at the start of dialysis was 147 ± 20 / 51 ± 5 mmHg. Among the 132 patients, there were 11 lethal events due to CVD. The risk of CVD death was significantly higher in the lowest systolic blood pressure patients (Q 1 ) than in highest blood pressure patients (Q 4 ) for 4 -years (Kaplan-Meier curve, log rank P = 0.035 ). In the multivariate Cox regression analysis, low systolic blood pressure was found to be independent risk factors for CVD mortality.

Conclusion

Hypotension at the start of dialysis is an independent risk factor of cardiovascular mortality.