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논문분류	춘계학술대회 초록집
제목	Intradialytic hypotension and worse outcomes in patients with acute kidney injury requiring intermittent hemodialysis
저자	Yeong-Won Park
출판정보	2023; 2023(1):
키워드
초록	Objectives: Intradialytic hypotension (IDH) is a critical factor related with worse outcomes in patients receiving maintenance hemodialysis. However, clinical outcomes of IDH in patients with severe acute kidney injury (AKI) requiring intermittent hemodialysis remains unresolved. Methods: The 1st hemodialysis sessions due to severe AKI (n = 1,046) were retrospectively reviewed. IDH was defined when a decrease in systolic blood pressure ≥30 mmHg and/or a nadir systolic blood pressure <90 mmHg occurred. Primary outcome was a transfer to intensive care unit (ICU) due to aggravating patient status. All-cause death was evaluated as an additional outcome. Hazard ratios (HRs) of outcomes were measured using Cox regression model after adjusting multiple variables. Results: IDH occurred in 286 patients (27%) during hemodialysis. The IDH cases had higher ICU transfer rates (18%) than non-IDH cases (11%) with adjusted HR of 1.41 (1.001.99) (P = 0.048). Patients exhibiting IDH had higher all-cause mortality than those without IDH (HR 1.36 (1.071.72) (P = 0.011). Factors, such as elderly, high pulse rate, hypoalbuminemia, diabetes mellitus, active cancer, and liver cirrhosis were associated with the risk of IDH. Conclusions: IDH occurrence in patients requiring hemodialysis due to AKI is associated with high risk of ICU transfer and death. Monitoring and early handling of IDH may improve patient outcomes.
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