Hemodialysis International最新文献

{"title":"Preemptive Vascular Access Placement and Mortality Risk in Hemodialysis Patients: A Real-World Single-Center Study","authors":"Wei Wang,&nbsp;Buyuan Tian,&nbsp;Xumao Deng,&nbsp;Ya Feng,&nbsp;Aijing Huang,&nbsp;Zaicheng Hu,&nbsp;Simeng Li,&nbsp;Cong Peng,&nbsp;Xiang Xiao","doi":"10.1111/hdi.70082","DOIUrl":"10.1111/hdi.70082","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The optimal timing for vascular access creation in hemodialysis (HD) patients is critical for improving patient outcomes. This study aimed to investigate the association between preemptive vascular access placement and all-cause mortality in HD patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort of 489 adult HD patients from 2009 to 2022 was analyzed. Patients were categorized into preemptive and non-preemptive vascular access groups. Inverse probability of treatment weighting (IPTW) was used to balance baseline characteristics, and survival analyses were performed using Kaplan–Meier curves, log-rank tests, and Cox proportional hazards models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Preemptive vascular access was found in 20.7% (101/489) of patients. After IPTW adjustment, the preemptive group had lower mortality (8.9% vs. 18.8%, <i>p</i> &lt; 0.001) and a 65% reduction in all-cause mortality risk (adjusted HR = 0.35, 95% CI 0.15–0.80). Elderly patients (≥ 60 years) showed greater survival benefits (<i>p</i> for interaction &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Preemptive vascular access placement significantly improves survival in HD patients, particularly in older adults. However, excessively early placement (&gt; 6 months) offers no additional prognostic advantage.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"30 3","pages":"563-572"},"PeriodicalIF":1.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147936613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimation of Excess Extracellular Fluid Volume Using Blood Volume Monitoring: A Comparison With Bioimpedance Spectroscopy. A Pilot Study","authors":"Shota Yoshizawa,&nbsp;Ai Akazawa,&nbsp;Takahiro Shinzato,&nbsp;Kazuhiko Shibata,&nbsp;Hisato Nagao,&nbsp;Takumi Ichikawa,&nbsp;Teruki Saito,&nbsp;Junji Uchino,&nbsp;Motoyuki Masai,&nbsp;Shigeru Nakai,&nbsp;Hirotaka Shibata,&nbsp;Takeshi Nakata","doi":"10.1111/hdi.70079","DOIUrl":"10.1111/hdi.70079","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Excess extracellular fluid volume (excess <i>V_ECF\u0000 </i>) is associated with poor prognosis in dialysis patients. Although bioimpedance spectroscopy is widely used to assess excess <i>V_ECF\u0000 </i> , it requires specialized equipment. The aim of this study was to develop a novel method to estimate excess <i>V_ECF\u0000 </i> based on blood volume monitoring data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We constructed a mathematical model to estimate excess <i>V_ECF\u0000 </i> using the relative blood volume at the end of dialysis. The estimated excess <i>V_ECF\u0000 </i> at the end of dialysis was compared with the bioimpedance spectroscopy-derived excess <i>V_ECF\u0000 </i> measured immediately after the same dialysis session. The correlation and agreement between the two methods were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A significant correlation was observed between blood volume-based and bioimpedance spectroscopy-derived excess <i>V_ECF\u0000 </i> (<i>r</i>\u0000 ² = 0.7526, <i>p</i> &lt; 0.0001). Bland–Altman analysis showed a fixed bias, indicating that blood volume-based excess <i>V_ECF\u0000 </i> systematically overestimated bioimpedance spectroscopy-derived excess <i>V_ECF\u0000 </i> at the end of dialysis, but no proportional bias was observed (mean difference = +0.86 L/m²; 95% limits of agreement = −1.10 to +2.82 L/m²; <i>r</i> = 0.046).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Possible sources of estimation error in blood volume-based excess <i>V_ECF\u0000 </i> include the assumption of isotonicity during dialysis and variability in the <i>f</i>-cell ratio.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The proposed blood volume-based method for estimating excess <i>V_ECF\u0000 </i> demonstrated a significant correlation with bioimpedance spectroscopy-derived values and may serve as a useful tool for volume assessment in dialysis patients. However, further validation is needed before it can be considered a substitute for bioimpedance spectroscopy as a standard method.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"30 3","pages":"635-644"},"PeriodicalIF":1.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Noise Levels of the Dialysis Machine Alarm on Patient Anxiety","authors":"Biplab Bera,&nbsp;P. Hemanth","doi":"10.1111/hdi.70080","DOIUrl":"10.1111/hdi.70080","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction and Background</h3>\u0000 \u0000 <p>Hemodialysis machine alarms are warning noises, which are essential for patient safety, but the psychological impact of these alarms is often overlooked. This study aims to assess the relationship between hemodialysis machine alarm noise levels and anxiety among patients undergoing thrice weekly hemodialysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This observational, cross-sectional, analytical study was conducted on 53 participants who were undergoing hemodialysis. A Benetech GM1351 digital sound-level meter was used to measure the noise level of hemodialysis machine alarms. Socio-demographic data and Hamilton Anxiety Rating Scale (HAM-A) were used for data collection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The range of noise level of hemodialysis machine alarms was detected from 48.5 to 77.8 dB(A). The study findings revealed that hemodialysis patients who are exposed to high intensity of the hemodialysis machine alarm have a negative impact on anxiety level in the hemodialysis unit. Females and participants with a higher level of education have higher anxiety levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Higher hemodialysis machine alarm noise had a significant impact on hemodialysis patients' anxiety. In addition, sex and educational status became predictors of anxiety. Future interventional research, such as alarm management protocols and tailored education programs to reduce anxiety among dialysis patients due to alarms, can provide meaningful insights.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"30 3","pages":"617-623"},"PeriodicalIF":1.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Exercise on Parathyroid Hormone Levels in Dialysis Patients: A Systematic Review and Meta-Analysis","authors":"Zhong Li,&nbsp;Yaxin Li,&nbsp;Qiaoling Jin,&nbsp;Menglin Chen,&nbsp;Nujia You,&nbsp;Linshen Xie","doi":"10.1111/hdi.70071","DOIUrl":"10.1111/hdi.70071","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Exercise has been increasingly recognized as a safe and effective adjunct therapy for improving physiological and biochemical outcomes in dialysis patients. However, its specific impact on parathyroid hormone (PTH) regulation remains uncertain. This systematic review and meta-analysis aimed to determine the effect of exercise interventions on PTH levels in adults undergoing dialysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of PubMed, Scopus, Embase, Web of Science, and Google Scholar databases was conducted up to October 31, 2025, without language or date restrictions. Eligible interventional studies compared exercise-based programs with standard dialysis care and reported quantitative PTH outcomes. Methodological quality was assessed using RoB 2.0 for randomized controlled trials and ROBINS-I for non-randomized trials. Pooled standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated using a random-effects model, with subgroup, sensitivity, and publication bias analyses performed to assess the robustness of results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nine eligible studies involving 438 dialysis patients were analyzed. Pooled results showed a significant reduction in PTH levels in the exercise groups compared with controls (SMD = −0.70; 95% CI: −1.00 to −0.40; <i>p</i> &lt; 0.001). This effect remained consistent across study designs, randomized controlled trials (SMD = −0.68) and non-randomized trials (SMD = −0.72), and across both short-term (≤ 12 weeks; SMD = −0.71; 95% CI: −0.99 to −0.42) and long-term (&gt; 12 weeks; SMD = −0.81; 95% CI: −1.37 to −0.25) interventions, with no significant subgroup difference. Sensitivity analysis confirmed that no single study significantly altered the pooled effect size, and funnel plot assessment with Egger's test indicated no publication bias (<i>p</i> = 0.181). Several individual trials also reported concurrent improvements in serum calcium and phosphate balance following exercise.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Exercise interventions significantly lower PTH levels in dialysis patients and may be integrated as a non-pharmacological adjunct to conventional secondary hyperparathyroidism management. Implementing structured physical activity during dialysis sessions can help improve mineral balance and endocrine stability. Further large-scale, multicenter randomized controlled trials with standardized protocols and longer follow-up periods are warranted to establish optimal exercise regimens for this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"30 3","pages":"463-477"},"PeriodicalIF":1.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, Predictors, and Challenges in the Management of Depression Among Patients on Hemodialysis in the Arab Countries: A Systematic Review","authors":"Mohammed Qutishat,&nbsp;Mohammed Al Alawi,&nbsp;Majdi Al-Hadidi,&nbsp;Loai Abu Sharour,&nbsp;Hamed Al- Sinawi,&nbsp;Nahla M. Al Ali,&nbsp;Eilean Lazarus","doi":"10.1111/hdi.70074","DOIUrl":"10.1111/hdi.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Depression is highly prevalent among patients undergoing hemodialysis in Arab countries, adversely affecting quality of life, treatment adherence, and clinical outcomes. Despite its significance, mental health issues remain underdiagnosed and undertreated due to cultural stigma, limited healthcare integration, and resource constraints.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This systematic review aims to evaluate the prevalence, key predictors, and management challenges of depression among hemodialysis patients in Arab countries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Following PRISMA guidelines, comprehensive searches of multiple databases were conducted for studies published from 2010 to June 2025. Inclusion criteria encompassed original quantitative, qualitative, and mixed-methods research focusing on depression in dialysis patients across Arab nations. Data extraction and quality assessment used standard tools, with a narrative synthesis employed to integrate findings due to heterogeneity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Analysis of 59 studies revealed a high prevalence of depression, averaging 55.6%, with rates ranging from 18% to 86.9%. Key predictors include female gender, older age, longer dialysis duration, low socioeconomic status, and comorbidities. Cultural stigma, lack of integrated mental health services, and limited provider training pose significant management barriers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The findings underscore the substantial mental health burden among dialysis patients, exacerbated by socio-cultural factors unique to the region. Addressing these challenges requires culturally sensitive screening, integrated psychosocial support, and healthcare system reforms to improve early diagnosis and treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Depression among hemodialysis patients in Arab countries is a critical public health issue, necessitating multidisciplinary, culturally tailored strategies to enhance mental health care, improve adherence, and elevate overall patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"30 3","pages":"439-462"},"PeriodicalIF":1.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemodiafiltration at Home: A Single Centre Experience Reviewing Safety, Efficacy, and Implementation","authors":"Maddison Taylor,&nbsp;Yeoungjee Cho,&nbsp;Rodney Brickle,&nbsp;Lisa Ditterich,&nbsp;Sheree Sodeman,&nbsp;Diana Leary,&nbsp;Carolyn van Eps","doi":"10.1111/hdi.70069","DOIUrl":"10.1111/hdi.70069","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Patients with kidney failure receiving dialysis are at an increased risk of cardiovascular events. Hemodiafiltration (HDF) has been shown to decrease cardiovascular mortality. Due to concerns around technical challenges and the need to achieve ultra-pure water standards, HDF is not readily available for those receiving hemodialysis at home. This study was conducted to describe the process and outcomes in implementing a home HDF program.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients who received home HDF training between 2014 and 2024 at the Princess Alexandra Hospital, Australia were included. The primary outcome was the proportion of patients who successfully completed training for HDF at home. Outcomes related to training duration, water, and clinical outcomes including hospitalizations, transfer to facility-based hemodialysis were analyzed descriptively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>In total, 42 patients (67% male, mean age 51.1 ± 12.8 years) undertook HDF therapy at home. About 39 patients commenced HDF training with a 100% training success rate, and 3 patients were supported by nursing-assisted HDF therapy at home. Median training duration was 61 days, which was longer for patients who were new to starting home dialysis (126 days), compared to those who converted from home hemodialysis to HDF (14.5 days, <i>p</i> &lt; 0.05). HDF prescriptions were highly variable (mean treatment hours 15.7 ± 4.9 h/week). The median time of home HDF treatment was 17.5 months (interquartile range IQR 9.9–31). In the first 6 months after starting HDF at home, there were no hospitalizations due to dialysis-related technical issues including water-related problems. Three patients (7%) transitioned to facility-based hemodialysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>HDF at home is a safe therapy for patients who are considered to receive hemodialysis at home, offering increased flexibility and personalized prescriptions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"30 3","pages":"525-533"},"PeriodicalIF":1.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147523310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bioelectrical Impedance in Pediatric Dialysis: Clinical Applications, Limitations, and Opportunities","authors":"Marisa Juarez-Calderon,&nbsp;Jessica Geer,&nbsp;Molly Wong Vega","doi":"10.1111/hdi.70073","DOIUrl":"10.1111/hdi.70073","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Optimizing fluid and nutritional management is a cornerstone of care for children with end-stage kidney disease on dialysis. Inaccurate assessment of hydration status contributes to hypertension, fluid overload, and increased cardiovascular risk, while masking important changes in muscle and fat compartments that affect growth and long-term outcomes. Bioelectrical impedance analysis (BIA) offers clinicians a noninvasive, rapid, and practical tool to support decision-making in this setting.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aims&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This review aims to provide clinicians with a practical framework for the use of BIA in pediatric dialysis, including its clinical applications, limitations, and opportunities for integration into routine care.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Materials and Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A narrative review of the literature was conducted, and findings were synthesized focusing on the principles of BIA, device technologies, and clinical studies evaluating its use in pediatric dialysis populations. Emphasis was placed on studies addressing fluid assessment, body composition, and clinical implementation. Adult literature was included where pediatric literature was lacking.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Available evidence suggests BIA can provide useful estimates of total body water, fat mass, and lean tissue that may support ultrafiltration strategies, nutritional assessment, and longitudinal monitoring. Key limitations include variability related to growth, delayed maturation, obesity, malnutrition, and reliance on adult-derived prediction equations. Current evidence supports BIA as an adjunctive tool integrated with clinical assessment rather than a standalone measure.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Discussion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;BIA may enhance individualized fluid and nutritional management when interpreted within the clinical context and standardized measurement protocols. Broader implementation requires awareness of pediatric-specific limitations, interdisciplinary interpretation, and cautious use of device-derived estimates.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;BIA is a practical adjunct for pediatric dialysis care with potential to improve fluid management and nutritional monitoring. Pediatric-specific validation studies, standardized protocols, and integration with clinical outc","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"30 3","pages":"486-498"},"PeriodicalIF":1.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hdi.70073","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pressor Response Index During Blood Return as a Marker for Identifying Intradialytic Hypotension","authors":"Ai Akazawa,&nbsp;Shota Yoshizawa,&nbsp;Takahito Ito,&nbsp;Takahiro Shinzato,&nbsp;Kazuhiko Shibata,&nbsp;Tomoya Horiba,&nbsp;Atsushi Kato,&nbsp;Daiki Sugiyama,&nbsp;Junji Uchino,&nbsp;Motoyuki Masai,&nbsp;Shigeru Nakai,&nbsp;Hirotaka Shibata,&nbsp;Takeshi Nakata","doi":"10.1111/hdi.70083","DOIUrl":"10.1111/hdi.70083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Intradialytic hypotension (IDH) is a frequent complication of hemodialysis (HD). Although nadir blood pressure–based definitions are prognostically relevant, their use in daily practice is limited because accurate identification requires frequent blood pressure monitoring. Because blood pressure (BP) is routinely measured during HD, the magnitude of the systolic BP rise during blood return may provide a simple and practical marker for identifying IDH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study was conducted at a single HD center. Study 1 evaluated factors associated with the pressor response index in 53 HD patients across 159 sessions using analysis of covariance (ANCOVA). Study 2 examined the ability of the index to discriminate HD sessions with and without IDH as defined by McCausland et al.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The pressor response index was significantly associated with maximum systolic BP drop and hypovolemic symptoms. The index clearly distinguished sessions with and without IDH. The effect size was large (Cohen's <i>d</i> = 1.41), and ROC analysis showed good discrimination (AUC 0.823). The optimal cut-off value was 10.3% (sensitivity 0.84, specificity 0.65).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The pressor response index may represent a simple, objective, and practical marker for identifying IDH in routine clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"30 3","pages":"600-604"},"PeriodicalIF":1.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"30 2","pages":"303-304"},"PeriodicalIF":1.2,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148070566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"30 2","pages":"374-383"},"PeriodicalIF":1.2,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148068688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}