Intra‐dialytic hypotension: Identifying patients most at risk

Sangala, Nicholas; Gangaram, Venkat; Atkins, Katey; Elliot, Graham; Lewis, Robert

doi:10.1111/jorc.12203

Cited by 4 publications

(5 citation statements)

References 21 publications

(22 reference statements)

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“…In 2 other studies, female gender was found to be a risk factor in combination with lower body weight [25,34], one of these studies also found small height as a risk factor [25]. Low predialysis SBP was reported as a risk factor for IDH in 3 studies [26,28,34,36], whereas another study identified a high SBP as a risk factor for IDH [25].…”

Section: Patient and Treatment Factors Associated With Idhmentioning

confidence: 99%

“…Of the 5 studies that did not provide detailed information of the definition used, 2 studies reported an IDH prevalence of 4.8 [26] and 5.5% [9] on session level (online suppl. File 3).…”

Section: Prevalence Of Idh On Session Levelmentioning

confidence: 99%

“…In the 5 studies that did not provide detailed information on the IDH definition, the proportion of patients with frequent IDH ranged between 4.8% [26] and 76.4% [6], (online suppl. Symptoms of IDH Symptoms of IDH and/or the need for nursing interventions were described in 8 studies using various definitions and methodology (online suppl.…”

Section: Proportion Of Patients With Frequent Idhmentioning

confidence: 99%

“…In 2 studies, the schedule was 2 HD sessions per week [19,30], and 2 other studies used a dialysis schedule of twice or thrice weekly with a minimum duration of 3 h per HD session [23,31]. In 4 studies, the dialysis duration was not specified [20,21,26,28]. One study described a retrospective survey with 369 patients on 2 HD sessions per week and a group of 741 patients on 3 HD sessions per week [18].…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

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The Prevalence of Intradialytic Hypotension in Patients on Conventional Hemodialysis: A Systematic Review with Meta-Analysis

et al. 2019

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Background: Intradialytic hypotension (IDH) is considered to be a frequent complication of hemodialysis (HD) and is associated with symptom burden, increased incidence of access failure, cardiovascular events, and higher mortality. This systematic literature review aims to analyse studies that investigated the prevalence of IDH. A complicating factor herein is that many different definitions of IDH are used in literature. Methods: A systematic literature search from databases, Medline, Cinahl, EMBASE, and the Cochrane library to identify studies reporting on the actual prevalence of IDH was conducted. Studies were categorized by the type of definition used for the prevalence of IDH. A meta-analysis of the prevalence of IDH was performed. Results: In a meta-analysis comprising 4 studies including 1,694 patients and 4 studies including 13,189 patients, the prevalence of HD sessions complicated by IDH was 10.1 and 11.6% for the European Best Practice Guideline (EBPG) definition and the Nadir <90 definition, respectively. The proportion of patients with frequent IDH could not reliably be established because of the wide range in cutoff values that were used to identify patients with frequent IDH. There was a large variety in the prevalence of symptoms and interventions. Major risk factors associated with IDH across studies were diabetes, a higher interdialytic weight gain, female gender, and lower body weight. Conclusion: Our meta-analysis suggests that the prevalence of IDH is lower than 12% for both the EBPG and the Nadir <90 definition which is much lower than stated in most reviews.

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Section: Patient and Treatment Factors Associated With Idhmentioning

confidence: 99%

“…Of the 5 studies that did not provide detailed information of the definition used, 2 studies reported an IDH prevalence of 4.8 [26] and 5.5% [9] on session level (online suppl. File 3).…”

Section: Prevalence Of Idh On Session Levelmentioning

confidence: 99%

Section: Proportion Of Patients With Frequent Idhmentioning

confidence: 99%

Section: Characteristics Of the Studiesmentioning

confidence: 99%

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The Prevalence of Intradialytic Hypotension in Patients on Conventional Hemodialysis: A Systematic Review with Meta-Analysis

et al. 2019

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“…The Na-P and SUF-P individualization application promoted intracellular fluid's extracellular transferring and added blood vessel refilling. [24][25][26] Furthermore, the T-P individualization application lowered the temperature of dialysate [27][28][29] and improved the stability of patient hemodynamics. 5,30 In addition, the combination of these three patterns strengthened the intervention mechanism of hypotension and was complementary.…”

Section: Discussionmentioning

confidence: 99%

Clinical research on individualized hemodialysis preventing unconventional hypotension in diabetic nephropathy patient

Yin

Chen

et al. 2019

Int J Artif Organs

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Objective: This study aims to evaluate the effectiveness of individualized hemodialysis for unconventional hypotension in diabetic nephropathy patients. Methods: A total of 60 patients were selected and randomly divided into study group and control group. The control group used the standard dialysis model, while the study group used the individualized hemodialysis scheme, in which the dialysis was performed using an individualized dialysis machine temperature control, pattern of natrium, and pattern of step ultrafiltration in combination with dialysate-containing glucose. Results: The total occurrence rate of hypotension, dry weight standard-reaching rate, and blood quality during and after dialysis in the study group were superior to those in the control group ( P < 0.05). Furthermore, the symptom scores in the study group (dizziness score, chest distress score, sweating score, muscle spasm score, gastrointestinal symptom score, and temporary mind change score) were lower than those in the control group ( P < 0.05). The serum sodium, potassium, and chloride concentration in these two groups after dialysis was not statistically different ( P > 0.05). Conclusion: The combined application of low temperature, pattern of natrium, pattern of step ultrafiltration, and dialysate-containing glucose individualization is safe and effective for preventing and controlling the occurrence of intradialytic hypotension (IDH), improve symptoms, and improve the dry weight standard-reaching rate.

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Machine learning-based intradialytic hypotension prediction of patients undergoing hemodialysis: A multicenter retrospective study

Dong

Wang

et al. 2023

Computer Methods and Programs in Biomedicine

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Intra‐dialytic hypotension: Identifying patients most at risk

Abstract: Delta systolic blood pressure is clinically useful in identifying patients most at risk of IDH. Anti-hypertensive medication use is associated with a lower delta systolic and a lower risk of IDH.

Cited by 4 publications

References 21 publications

The Prevalence of Intradialytic Hypotension in Patients on Conventional Hemodialysis: A Systematic Review with Meta-Analysis

The Prevalence of Intradialytic Hypotension in Patients on Conventional Hemodialysis: A Systematic Review with Meta-Analysis

Clinical research on individualized hemodialysis preventing unconventional hypotension in diabetic nephropathy patient

Machine learning-based intradialytic hypotension prediction of patients undergoing hemodialysis: A multicenter retrospective study

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