Mean annual intradialytic blood pressure decline and cardiovascular events in Japanese patients on maintenance hemodialysis

Takahashi, Rina; Uchiyama, Kiyotaka; Washida, Naoki; Shibagaki, Keigo; Yanai, Akane; Nakayama, Takashin; Nagashima, Kengo; Sato, Yasunori; Kanda, Takeshi; Itoh, Hiroshi

doi:10.1038/s41440-023-01228-8

Hypertens Res

2023

DOI: 10.1038/s41440-023-01228-8

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Mean annual intradialytic blood pressure decline and cardiovascular events in Japanese patients on maintenance hemodialysis

Rina Takahashi

Kiyotaka Uchiyama

Naoki Washida

et al.

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Cited by 3 publications

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“…On the other hand, Japanese data on blood pressure variability and prognosis in dialysis patients are limited. A retrospective study by Takahashi et al examined the reduction in blood pressure during dialysis and the risk of developing major adverse cardiovascular events (MACE) in Japanese patients [10]. Patients were divided into three groups based on the degree of blood pressure decline during dialysis, and their prognosis was examined.…”

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confidence: 99%

Blood pressure management in hemodialysis patients

Hirawa

2023

Hypertens Res

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mentioning

confidence: 99%

Blood pressure management in hemodialysis patients

Hirawa

2023

Hypertens Res

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External validation of the prediction model of intradialytic hypotension: a multicenter prospective cohort study

Xiang,

Ma,

Yang

et al. 2024

Renal Failure

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Objective Intradialytic hypotension (IDH) is a common and serious complication in patients with Maintenance Hemodialysis (MHD). The purpose of this study is to externally verify three IDH risk prediction models recently developed by Ma et al. and recalibrate, update and present the optimal model to improve the accuracy and applicability of the model in clinical environment. Methods A multicenter prospective cohort study of patients from 11 hemodialysis centers in Sichuan Province, China, was conducted using convenience sampling from March 2022 to July 2022, with a follow-up period of 1 month. Model performance was assessed by: (1) Discrimination: Evaluated through the computation of the Area Under Curve (AUC) and its corresponding 95% confidence intervals. (2) Calibration: scrutinized through visual inspection of the calibration plot and utilization of the Brier score. (3) The incremental value of risk prediction and the utility of updating the model were gauged using NRI (Net Reclassification Improvement) and IDI (Integrated Discrimination Improvement). Decision Curve Analysis (DCA) was employed to evaluate the clinical benefit of updating the model. Results The final cohort comprised 2235 individuals undergoing maintenance hemodialysis, exhibiting a 14.6% occurrence rate of IDH. The externally validated Area Under the Curve (AUC) values for the three original prediction models were 0.746 (95% CI: 0.718 to 0.775), 0.709 (95% CI: 0.679 to 0.739), and 0.735 (95% CI: 0.706 to 0.764) respectively. Conversely, the AUC value for the recalibrated and updated columnar plot model reached 0.817 (95% CI: 0.791 to 0.842), accompanied by a Brier score of 0.081. Furthermore, Decision Curve Analysis (DCA) exhibited a net benefit within the threshold probability range of 15.2% to 87.1%. Conclusion Externally validated, recalibrated, updated, and presented IDH prediction models may serve as a valuable instrument for evaluating IDH risk in clinical practice. Furthermore, they hold the potential to guide clinical providers in discerning individuals at risk and facilitating judicious clinical intervention decisions.

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Higher atherogenic index of plasma is associated with intradialytic hypotension: a multicenter cross-sectional study

Peng,

Shuai,

Yang

et al. 2024

Renal Failure

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Mean annual intradialytic blood pressure decline and cardiovascular events in Japanese patients on maintenance hemodialysis

Cited by 3 publications

References 31 publications

Blood pressure management in hemodialysis patients

Blood pressure management in hemodialysis patients

External validation of the prediction model of intradialytic hypotension: a multicenter prospective cohort study

Higher atherogenic index of plasma is associated with intradialytic hypotension: a multicenter cross-sectional study

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