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Multimodality Diagnosis of Mesenteric Ischemia
05:07

Multimodality Diagnosis of Mesenteric Ischemia

Published on: July 21, 2023

Factors associated with mortality from non-occlusive mesenteric ischemia in dialysis patients

Chen-Chao Yu1, Heng-Jung Hsu, I-Wen Wu

  • 1Division of Nephrology, Chang Gung Memorial Hospital, Keelung, Taiwan.

Renal Failure
|November 21, 2009
PubMed
Abstract

Insights

Non-occlusive mesenteric ischemia (NOMI) is rare in dialysis patients but deadly. Chronic hypotension and cyclooxygenase (COX) inhibitor use are linked to higher NOMI mortality, warranting caution.

Area of Science:

  • Nephrology
  • Gastroenterology
  • Critical Care Medicine

Background:

  • Non-occlusive mesenteric ischemia (NOMI) is a severe complication in dialysis patients with high mortality.
  • Prognostic factors for NOMI in this population are not well-established.

Purpose of the Study:

  • To identify prognostic factors associated with mortality in dialysis patients diagnosed with NOMI.

Main Methods:

  • Retrospective review of 699 dialysis patients (hemodialysis and peritoneal dialysis) from January 2007 to December 2008.
  • Diagnosis of NOMI confirmed by surgical and/or radiological criteria.
  • Analysis of 12 dialysis patients who developed NOMI.

Main Results:

  • NOMI incidence was 1.04% per patient-year in dialysis patients.
  • The majority of NOMI patients (83.3%) had chronic hypotension.
  • Mortality was significantly higher in patients administered cyclooxygenase (COX) inhibitors prior to ischemia and those with hypobicarbonemia.

Conclusions:

  • NOMI is an infrequent but serious condition in dialysis patients.
  • Caution is advised when administering COX inhibitors to long-term hypotensive dialysis patients.
  • Hypobicarbonemia may indicate severe hypoperfusion and is associated with increased mortality.

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