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Hemodialysis Immediately After Cardiac Catheterization Is a Risk Factor for Intradialytic Hypotension
Author(s) -
Irifuku Taisuke,
Naito Takayuki,
Ogawa Takahiko,
Shimizu Yuka,
Maeoka Yujiro,
Masaki Takao
Publication year - 2015
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/1744-9987.12252
Subject(s) - medicine , odds ratio , confidence interval , hemodialysis , incidence (geometry) , blood pressure , cardiac catheterization , cardiology , logistic regression , risk factor , stenosis , surgery , optics , physics
Many hemodialysis clinicians have noticed that patients frequently develop intradialytic hypotension ( IDH ) immediately after cardiac catheterization ( CC ). However, precise data about the incidence of IDH immediately after CC are scarce. This study involved a single‐center, retrospective, cross‐sectional design. We reviewed the medical records of all HD patients who underwent CC between J anuary 2009 and M arch 2012 at Hiroshima Prefectural Hospital. IDH was defined as a fall of systolic blood pressure of more than 20 mm Hg or a fall of mean blood pressure of more than 10 mm Hg, with symptoms according to the K / DOQI criteria. Data on a total of 112 patients were obtained: 64 patients commenced HD immediately after CC ( IA group) and 48 patients underwent HD on the day after CC ( ND group). The overall incidence of IDH was 34% (38/112). The incidence of IDH was significantly higher in the IA group than in the ND group (27/64, 42% vs. 11/48, 23%; P < 0.05). Multivariate logistic regression analysis showed that IA (odds ratio, 5.39; 95% confidence interval, 1.76 to 16.49; P < 0.01), coronary stenosis (odds ratio, 4.16; 95% confidence interval, 1.49 to 11.64; P < 0.05) were independently associated with IDH . This study revealed that HD immediately after CC is associated with a higher incidence of IDH . Clinicians should consider that HD following CC be scheduled for the next day, especially in patients with coronary stenosis.