Kidney Week

Abstract: FR-PO0483

Patterns of Intradialytic Hypotension: Prevalence and Patient Profiles in Europe

Session Information

• Dialysis: Hemodiafiltration, Ultrafiltration, Profiling, and Interdialytic Symptoms
  November 07, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Croft, Kaitlyn Renee, Renal Research Institute, New York, New York, United States

Kaitlyn Renee Croft, MSc

• Ficociello, Linda, Renal Research Institute, New York, New York, United States

Linda Ficociello, PhD

• Arkossy, Otto, Fresenius Medical Care Deutschland GmbH, Bad Homburg, HE, Germany

Otto Arkossy

• Winter, Anke, Renal Research Institute, New York, New York, United States

Anke Winter, MD

• Larkin, John W., Renal Research Institute, New York, New York, United States

John W. Larkin, PhD

• Guinsburg, Adrian M., Fresenius Medical Care Deutschland GmbH, Bad Homburg, HE, Germany

Adrian M. Guinsburg, MD

• Usvyat, Len A., Renal Research Institute, New York, New York, United States

Len A. Usvyat, PhD

Background

Intradialytic hypotension (IDH) is associated with negative short- and long-term outcomes in hemodialysis patients and is estimated to occur in nearly 10-12% of treatments. We aimed to explore patient and treatment parameters associated with IDH in HD patients treated in 12 countries in Europe using version one of the global database ApolloDialDb^TM.

Methods

ApolloDialDb includes adult dialysis patient data from a global kidney network from Jan 2018-Mar 2021. We included both incident and prevalent patients and evaluated their treatments over 6 months. Patients with missing comorbidities were excluded. Intradialytic hypotension was present if the lowest systolic blood pressure during dialysis was < 90 mmHg. Three IDH event groups were created (none, 0.1%-10%, >10%) based on the percent of treatments that included an IDH event.

Results

A total of 29,134 patients were analyzed, 9,651 patients had no IDH events, 11,611 patients had 0.1%-10% IDH events and 7,872 had more than 10% IDH events in their treatments over 6 months. Figure 1 shows differences in demographic and treatment characteristics of each patient group. Patients with more IDH events are more likely to be female, diabetic, have a cardiovascular disease (CVD), older, underweight and have a longer vintage. Treatment-level characteristics associated with more IDH events were higher ultrafiltration rates, ultrafiltration volume and dialyzed with graft or catheter vascular access.

Conclusion

Our study showed significant differences across all 3 IDH event groups in both patient and treatment characteristics. Further studies are needed to identify tailored treatment strategies to prevent IDH occurrences among these specific patient subgroups.

Table 1. Patient and treatment parameters between IDH event groups.

Funding

• Commercial Support – Renal Research Institute, Fresenius Medical Care

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025vjbbq6tj