We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Associations between body composition and intradialytic hypotension (IDH), and between IDH and prognosis, in hemodialysis patients.
- Authors
Mizuiri, Sonoo; Nishizawa, Yoshiko; Doi, Toshiki; Okubo, Aiko; Morii, Kenichi; Yamashita, Kazuomi; Suga, Yukari; Usui, Koji; Shigemoto, Kenichiro; Masaki, Takao
- Abstract
Background: Previous studies describing relationships among body compositions, intradialytic hypotension (IDH), and mortality yielded inconsistent results. We studied associations between body composition and IDH, and between IDH and prognosis, in patients on hemodialysis (HD). Methods: Participants were patients on maintenance HD and predilution online hemodiafiltration (HDF) (n = 303). IDH was defined as nadir systolic blood pressure (SBP) < 90 mmHg for ≥ 2 of 10 dialysis sessions during the exposure period (days 1–22). Clinical data at day 1 and post-dialysis body compositions using bioelectrical impedance analysis conducted once during the exposure period were collected. Differences between the IDH and non-IDH groups were analyzed. Kaplan–Meier survival curves of the IDH and non-IDH groups, logistic regression analyses of IDH, and Cox proportional hazard analyses of all-cause and cardiovascular (CV) mortality in all participants were also performed. Results: In all participants, the median (median [interquartile range]) age was 67 [56–74] years, median dialysis duration was 76 [37–145] months, and diabetes prevalence was 42.6% (129/303). Compared with the non-IDH group (n = 274), the IDH group (n = 29) had a lower mean pre-dialysis SBP during the exposure period, longer dialysis duration, lower serum albumin levels, and higher median fat tissue index (10.7 [8.6–14.9] versus 9.5 [6.8–11.9] kg/m2, P < 0.05). The IDH group had lower 3-year survival for all-cause and CV mortality (P < 0.05). When adjusted for mean pre-dialysis SBP, mean ultrafiltration volume during the exposure period, HDF, dialysis duration, and serum albumin, fat tissue index, and lean tissue index were associated with IDH (P < 0.05), but body mass index and overhydration/extracellular water were not. After additional adjustments for age, sex, and diabetes mellitus, only fat tissue index was a significant predictor for IDH [odds ratio: 1.12 (95% confidence interval 1.02–1.25), P < 0.05]. IDH was also a significant predictor of 3-year all-cause and CV mortality (P < 0.05). Conclusions: Increased fat tissue index was a significant risk factor for IDH in HD and HDF patients. Furthermore, IDH was a significant predictor of 3-year all-cause and CV mortality in HD and HDF patients.
- Subjects
STATISTICAL correlation; HEMODIAFILTRATION; ULTRAFILTRATION; MORTALITY; CARDIOVASCULAR diseases; ADIPOSE tissues; BODY mass index; PHYSIOLOGIC salines; T-test (Statistics); NEPHROSCLEROSIS; RESEARCH funding; BODY composition; LOGISTIC regression analysis; SCIENTIFIC observation; DIABETIC nephropathies; HEMODIALYSIS; BIOELECTRIC impedance; DESCRIPTIVE statistics; RETROSPECTIVE studies; TREATMENT duration; ANTIHYPERTENSIVE agents; MANN Whitney U Test; CHI-squared test; KAPLAN-Meier estimator; EXTRACELLULAR fluid; ODDS ratio; GLOMERULONEPHRITIS; POLYCYSTIC kidney disease; LOG-rank test; LONGITUDINAL method; ELECTROCARDIOGRAPHY; RESEARCH; SYSTOLIC blood pressure; COMPARATIVE studies; CONFIDENCE intervals; HEALTH outcome assessment; VASOCONSTRICTORS; DATA analysis software; CORONARY artery calcification; BLOOD pressure; KIDNEY diseases; HYPOTENSION; DIABETES; PROPORTIONAL hazards models; SERUM albumin; C-reactive protein; MULTIDETECTOR computed tomography; DISEASE risk factors
- Publication
Renal Replacement Therapy, 2024, Vol 10, Issue 1, p1
- ISSN
2059-1381
- Publication type
Article
- DOI
10.1186/s41100-024-00550-2