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Hemodialysis immediately after cardiac catheterization is a risk factor for intradialytic hypotension

Taisuke Irifuku1, Takayuki Naito2, Takahiko Ogawa2

  • 1Department of Nephrology, Hiroshima University Hospital, Hiroshima, Japan.

Therapeutic Apheresis and Dialysis : Official Peer-Reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy
|December 17, 2014
PubMed

Insights

Hemodialysis (HD) patients undergoing cardiac catheterization (CC) face a higher risk of intradialytic hypotension (IDH) if HD begins immediately after CC. Scheduling HD for the next day can reduce this risk, especially for patients with coronary stenosis.

Area of Science:

  • Nephrology
  • Cardiology
  • Clinical Medicine

Background:

  • Intradialytic hypotension (IDH) is a common complication during hemodialysis (HD).
  • Clinicians observe a frequent occurrence of IDH in patients immediately following cardiac catheterization (CC).
  • Limited precise data exist on the incidence of IDH specifically after CC.

Purpose of the Study:

  • To investigate the incidence of IDH in hemodialysis patients immediately after cardiac catheterization.
  • To identify risk factors associated with IDH in this patient population.
  • To provide evidence-based recommendations for timing HD post-CC.

Main Methods:

  • Single-center, retrospective, cross-sectional study design.
  • Review of medical records for 112 hemodialysis patients who underwent cardiac catheterization between January 2009 and March 2012.
  • Comparison of IDH incidence between patients undergoing HD immediately after CC (IA group) and those undergoing HD the day after CC (ND group).

Main Results:

  • The overall incidence of IDH was 34% (38/112).
  • IDH incidence was significantly higher in the IA group (42%) compared to the ND group (23%) (P < 0.05).
  • Immediate HD post-CC (odds ratio, 5.39) and coronary stenosis (odds ratio, 4.16) were independently associated with IDH.

Conclusions:

  • Hemodialysis immediately following cardiac catheterization is associated with a significantly higher incidence of intradialytic hypotension.
  • Scheduling hemodialysis for the day after cardiac catheterization may reduce the risk of IDH.
  • Consideration should be given to delaying hemodialysis until the day after cardiac catheterization, particularly in patients with coronary stenosis.

Keywords:
Cardiac catheterizationCoronary stenosisHemodialysisIntradialytic hypotensionMyocardial stunning

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