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The relationship between intradialytic hypotension and vascular calcification in hemodialysis patients

AJin Cho1, Young-Ki Lee1, Jieun Oh2

  • 1Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University, Hallym University College of Medicine, Seoul, Korea.

Plos One
|October 20, 2017
PubMed

Insights

Intradialytic hypotension (IDH) is linked to abdominal aortic calcification (AACS) in hemodialysis patients. Combined IDH and high AACS significantly increase cardiovascular event risk.

Area of Science:

  • Nephrology
  • Cardiology
  • Radiology

Background:

  • Vascular calcification is a known complication in hemodialysis (HD) patients.
  • Intradialytic hypotension (IDH) is common in HD and may affect cardiovascular health.

Purpose of the Study:

  • To investigate the association between IDH and abdominal aortic calcification (AACS) in HD patients.
  • To determine the impact of IDH and AACS on cardiovascular events (CVEs).

Main Methods:

  • 191 maintenance HD patients underwent abdominal radiography for AACS.
  • IDH was defined as >2 episodes of hypotension during 10 HD treatments.
  • Hypotension was quantified by nadir systolic BP < 90 mm Hg or fluid administration.

Main Results:

  • IDH occurred in 32 patients; AACS was significantly higher in the IDH group (8.4 vs. 4.9, P=0.001).
  • High AACS was an independent risk factor for CVEs (OR=1.09, P=0.03).
  • Patients with both IDH and high AACS (≥4) had the highest CVE rate (27.9%, P=0.008) and were significant predictors of CVE (HR=2.84, P=0.04).

Conclusions:

  • IDH is associated with increased abdominal aortic calcification in HD patients.
  • Both IDH and high AACS are independent risk factors for cardiovascular events in this population.
Abstract

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