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Nonocclusive mesenteric infarction in hemodialysis patients
A S John1, S D Tuerff, M D Kerstein
1Medical College of Pennsylvania-Hahnemann University School of Medicine, Philadelphia, USA.
Journal of the American College of Surgeons
|January 7, 2000
Summary
Nonocclusive mesenteric ischemia (NOMI) is more common in dialysis patients. Identifying high-risk individuals and monitoring filtration rates may reduce the high mortality associated with NOMI.
Area of Science:
- Nephrology
- Gastroenterology
- Vascular Surgery
Background:
- Nonocclusive mesenteric ischemia (NOMI) affects hemodialysis patients at a higher rate.
- Atherosclerosis and hypotension during hemodialysis are potential contributing factors.
- A retrospective review identified risk factors and outcomes in hemodialysis patients with NOMI.
Purpose of the Study:
- To identify risk factors for NOMI development in long-term hemodialysis patients.
- To assess the outcomes and mortality rates associated with NOMI in this population.
Main Methods:
- Retrospective review of 29 hemodialysis patients with NOMI.
- Comparison with a control group of hemodialysis patients without NOMI.
- Analysis of patient data including comorbidities, symptoms, and laboratory findings.
Main Results:
- NOMI patients frequently experienced hypotension during dialysis prior to symptom onset.
- Common risk factors included hypertension (83%), diabetes (55%), and atherosclerosis (38%).
- Overall mortality for NOMI was 45%, with higher mortality in cases of small bowel ischemia.
Conclusions:
- NOMI is a significant concern in the hemodialysis population.
- Early identification of high-risk patients is crucial.
- Careful monitoring of filtration rates may help mitigate NOMI and its associated mortality.