Comparison of intradialytic blood pressure metrics as predictors of all-cause mortality
- Authors
- Kim, Ka Young; Park, Hae Sang; Kim, Jin Sun; Ahn, Shin Young; Ko, Gang Jee; Kwon, Young Joo; Kim, Ji Eun
- Issue Date
- 12월-2021
- Publisher
- OXFORD UNIV PRESS
- Keywords
- blood pressure; end-stage renal disease; hemodialysis; intradialytic hypotension; mortality; prediction; receiver operating characteristics
- Citation
- CLINICAL KIDNEY JOURNAL, v.14, no.12, pp.2600 - 2605
- Indexed
- SCIE
SCOPUS
- Journal Title
- CLINICAL KIDNEY JOURNAL
- Volume
- 14
- Number
- 12
- Start Page
- 2600
- End Page
- 2605
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/135677
- DOI
- 10.1093/ckj/sfab124
- ISSN
- 2048-8505
- Abstract
- Background. Intradialytic hypotension (IDH) has been reported to be an important prognostic factor in hemodialysis patients. However, a standard definition of IDH has not yet been determined. Methods. We retrospectively analyzed blood pressure (BP) metrics obtained during serial dialysis sessions over a 90-day period from a single dialysis center from 2016 to 2017. The mean values and the frequency of specific values of BP were analyzed as predictors of 3-year mortality. Results. A total of 430 patients who underwent maintenance dialysis were included. The mean age was 63.3 12.4 years and 58.6% were male. A low minimum systolic blood pressure (SBP) <110 mmHg during dialysis was significantly associated with increased all-cause mortality. The frequency of a minimum SBP <100 mmHg was the most significant predictor of 3-year mortality, with an area under the curve (AUC) of 0.722. Furthermore, the frequency of a minimum SBP <100 mmHg significantly increased the predictability of mortality when combined with the presence of other clinical factors including age, body mass index and vascular access type (AUC 0.786 vs. 0.835; p = 0.005). Conclusion. Among the various intradialytic BP metrics, the frequency of a minimum SBP <100 mmHg is the most significant factor related to all-cause mortality. The guidelines for the management of blood pressure in dialysis patients should consider including a minimum SBP <100 mmHg as a definition for IDH.
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