The Effect of Frequent and Occasional Dialysis‐Associated Hypotension on Survival of Patients on Hemodialysis
Identifieur interne : 005660 ( Main/Exploration ); précédent : 005659; suivant : 005661The Effect of Frequent and Occasional Dialysis‐Associated Hypotension on Survival of Patients on Hemodialysis
Auteurs : A. Tislér [Hongrie] ; K. Ak Csi [Hongrie] ; B. Borbás [Hongrie] ; L. Fazakas [Hongrie] ; S. Ferenczi [Hongrie] ; S. Görögh [Hongrie] ; I. Kulcsár [Hongrie] ; L. Nagy [Hongrie] ; J. Sámik [Hongrie] ; J. Szegedi [Hongrie] ; E. T Th [Hongrie] ; G. Wágner [Hongrie] ; I. Kiss [Hongrie]Source :
- Hemodialysis International [ 1492-7535 ] ; 2004-01.
Abstract
Frequent or occasional symptomatic intradialytic hypotension during hemodialysis may influence patients' well being, but its effects on survival, independent of comorbidities, have not previously been investigated. Objective: To assess the effect of frequent (f‐IDH) or occasional (o‐IDH) dialysis‐associated hypotension on survival. Methods: During the run in period in 1998, 77 patients with f‐IDH (≥10 hypotensive events/10 months, responding only to medical intervention) and 101 patients with o‐IDH (1 or 2 events/10 months) were identified among all 958 prevalent chronic hemodialysis patients of a network. Eighty‐five patients who had no hypotensive episodes (no‐IDH) served as controls. Patients were followed for a median of 27 months (range 0.3–37), and survival of patients was compared by log‐rank test. Independent association of f‐IDH and o‐IDH on survival, compared to no‐IDH, was assessed by proportional hazards model that included patient's demographics, laboratory data, comorbidity as well as medications. Results: Forty‐five patients (58%) with f‐IDH, 47 (47%) with o‐IDH, and 33 (39%) with no‐IDH died during the follow up that represents mortality rates of 37 (p = 0.013 vs. no‐IDH), 26 (p = 0.375 vs. no‐IDH), and 21 deaths/100 patient years in the three groups, respectively. In multivariate proportional hazards regression, where age, sex, time on dialysis, CHD, diabetes, Kt/V, albumin level, use of beta‐blockers, calcium‐channel blockers, and long‐acting nitrates have been adjusted for, neither f‐IDH nor o‐IDH was associated with survival. Conclusion: Mortality in patients with f‐IDH is significantly higher than in those without such events. Our data, however, did not provide evidence that f‐IDH, independent of age and comorbidities, contributes to mortality in these patients.
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DOI: 10.1111/j.1492-7535.2004.0085ah.x
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T Th</name><affiliation wicri:level="3"><country xml:lang="fr">Hongrie</country><wicri:regionArea>EuroCare Nephrological Network, 1st Department of Medicine, Semmelweis University, Budapest</wicri:regionArea><placeName><settlement type="city">Budapest</settlement><region nuts="2">Hongrie centrale</region></placeName></affiliation></author><author><name sortKey="Wagner, G" sort="Wagner, G" uniqKey="Wagner G" first="G." last="Wágner">G. Wágner</name><affiliation wicri:level="3"><country xml:lang="fr">Hongrie</country><wicri:regionArea>EuroCare Nephrological Network, 1st Department of Medicine, Semmelweis University, Budapest</wicri:regionArea><placeName><settlement type="city">Budapest</settlement><region nuts="2">Hongrie centrale</region></placeName></affiliation></author><author><name sortKey="Kiss, I" sort="Kiss, I" uniqKey="Kiss I" first="I." last="Kiss">I. Kiss</name><affiliation wicri:level="3"><country xml:lang="fr">Hongrie</country><wicri:regionArea>EuroCare Nephrological Network, 1st Department of Medicine, Semmelweis University, Budapest</wicri:regionArea><placeName><settlement type="city">Budapest</settlement><region nuts="2">Hongrie centrale</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Hemodialysis International</title><title level="j" type="alt">HEMODIALYSIS INTERNATIONAL</title><idno type="ISSN">1492-7535</idno><idno type="eISSN">1542-4758</idno><imprint><biblScope unit="vol">8</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="91">91</biblScope><biblScope unit="page" to="91">91</biblScope><biblScope unit="page-count">100</biblScope><publisher>Blackwell Science Inc</publisher><pubPlace>Oxford, UK; Malden, USA</pubPlace><date type="published" when="2004-01">2004-01</date></imprint><idno type="ISSN">1492-7535</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1492-7535</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Frequent or occasional symptomatic intradialytic hypotension during hemodialysis may influence patients' well being, but its effects on survival, independent of comorbidities, have not previously been investigated. Objective: To assess the effect of frequent (f‐IDH) or occasional (o‐IDH) dialysis‐associated hypotension on survival. Methods: During the run in period in 1998, 77 patients with f‐IDH (≥10 hypotensive events/10 months, responding only to medical intervention) and 101 patients with o‐IDH (1 or 2 events/10 months) were identified among all 958 prevalent chronic hemodialysis patients of a network. Eighty‐five patients who had no hypotensive episodes (no‐IDH) served as controls. Patients were followed for a median of 27 months (range 0.3–37), and survival of patients was compared by log‐rank test. Independent association of f‐IDH and o‐IDH on survival, compared to no‐IDH, was assessed by proportional hazards model that included patient's demographics, laboratory data, comorbidity as well as medications. Results: Forty‐five patients (58%) with f‐IDH, 47 (47%) with o‐IDH, and 33 (39%) with no‐IDH died during the follow up that represents mortality rates of 37 (p = 0.013 vs. no‐IDH), 26 (p = 0.375 vs. no‐IDH), and 21 deaths/100 patient years in the three groups, respectively. In multivariate proportional hazards regression, where age, sex, time on dialysis, CHD, diabetes, Kt/V, albumin level, use of beta‐blockers, calcium‐channel blockers, and long‐acting nitrates have been adjusted for, neither f‐IDH nor o‐IDH was associated with survival. Conclusion: Mortality in patients with f‐IDH is significantly higher than in those without such events. Our data, however, did not provide evidence that f‐IDH, independent of age and comorbidities, contributes to mortality in these patients.</div></front></TEI><affiliations><list><country><li>Hongrie</li></country><region><li>Hongrie centrale</li></region><settlement><li>Budapest</li></settlement></list><tree><country name="Hongrie"><region name="Hongrie centrale"><name sortKey="Tisler, A" sort="Tisler, A" uniqKey="Tisler A" first="A." last="Tislér">A. Tislér</name></region><name sortKey="Ak Csi, K" sort="Ak Csi, K" uniqKey="Ak Csi K" first="K." last="Ak Csi">K. Ak Csi</name><name sortKey="Borbas, B" sort="Borbas, B" uniqKey="Borbas B" first="B." last="Borbás">B. Borbás</name><name sortKey="Fazakas, L" sort="Fazakas, L" uniqKey="Fazakas L" first="L." last="Fazakas">L. Fazakas</name><name sortKey="Ferenczi, S" sort="Ferenczi, S" uniqKey="Ferenczi S" first="S." last="Ferenczi">S. Ferenczi</name><name sortKey="Gorogh, S" sort="Gorogh, S" uniqKey="Gorogh S" first="S." last="Görögh">S. Görögh</name><name sortKey="Kiss, I" sort="Kiss, I" uniqKey="Kiss I" first="I." last="Kiss">I. Kiss</name><name sortKey="Kulcsar, I" sort="Kulcsar, I" uniqKey="Kulcsar I" first="I." last="Kulcsár">I. Kulcsár</name><name sortKey="Nagy, L" sort="Nagy, L" uniqKey="Nagy L" first="L." last="Nagy">L. Nagy</name><name sortKey="Samik, J" sort="Samik, J" uniqKey="Samik J" first="J." last="Sámik">J. Sámik</name><name sortKey="Szegedi, J" sort="Szegedi, J" uniqKey="Szegedi J" first="J." last="Szegedi">J. Szegedi</name><name sortKey="T Th, E" sort="T Th, E" uniqKey="T Th E" first="E." last="T Th">E. T Th</name><name sortKey="Wagner, G" sort="Wagner, G" uniqKey="Wagner G" first="G." last="Wágner">G. Wágner</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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