经常性血液透析内低血压与血液透析患者临床预后的关系:一项前瞻性队列研究。

IF 3 3区 医学 Q1 UROLOGY & NEPHROLOGY
Renal Failure Pub Date : 2024-12-01 Epub Date: 2024-01-04 DOI:10.1080/0886022X.2023.2296612
Yuanhao Wu, Jianda Lu, Tingting Wang, Xiaoye Zhu, Jun Xue, Li You
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引用次数: 0

摘要

析出内低血压(IDH)是血液透析(HD)的常见并发症,但对其定义尚未达成共识。2015 年,Flythe 提出了 IDH 的定义(本研究中的定义 1):脐带收缩压 (SBP) p = 0.009,定义 1;p = 0.002,定义 2)和心血管死亡率(p = 0.021,定义 1)。多变量 Cox 回归分析表明,频繁 IDH 与较高的全因死亡风险独立相关(模型 1:HR = 2.553,95%CI 1.334-4.886,p = 0.005;模型 2:HR = 2.406,95%CI 1.253-4.621,p = 0.008)。总之,经常出现 IDH 的 HD 患者全因死亡的风险更高。这凸显了承认并积极管理 HD 患者中的频繁 IDH 的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association of frequent intradialytic hypotension with the clinical outcomes of patients on hemodialysis: a prospective cohort study.

Intradialytic hypotension (IDH) is a common complication of hemodialysis (HD), but there is no consensus on its definition. In 2015, Flythe proposed a definition of IDH (Definition 1 in this study): nadir systolic blood pressure (SBP) <90 mmHg during hemodialysis for patients with pre-dialysis SBP <159 mmHg, and nadir SBP <100 mmHg during hemodialysis for patients with pre-dialysis SBP ≥160 mmHg. This prospective observational cohort study investigated the association of frequent IDH based on Definition 1 with clinical outcomes and compared Definition 1 with a commonly used definition (nadir SBP <90 mmHg during hemodialysis, Definition 2). The incidence of IDH was observed over a 3-month exposure assessment period. Patients with IDH events ≥30% were classified as 'frequent IDH'; the others were 'infrequent IDH'. All-cause mortality, cardiovascular mortality, and all-cause hospitalization events were followed up for 36 months. This study enrolled 163 HD patients. The incidence of IDH was 11.1% according to Definition 1 and 10.5% according to Definition 2. The Kaplan-Meier curves showed that frequent IDH patients had higher risks of all-cause mortality (p = 0.009, Definition 1; p = 0.002, Definition 2) and cardiovascular mortality (p = 0.021, Definition 1). Multivariable Cox regression analysis indicated that frequent IDH was independently associated with a higher risk of all-cause mortality (Model 1: HR = 2.553, 95%CI 1.334-4.886, p = 0.005; Model 2: HR = 2.406, 95%CI 1.253-4.621, p = 0.008). In conclusion, HD patients classified as frequent IDH are at a greater risk of all-cause mortality. This highlights the significance of acknowledging and proactively managing frequent IDH within the HD patients.

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来源期刊
Renal Failure
Renal Failure 医学-泌尿学与肾脏学
CiteScore
3.90
自引率
13.30%
发文量
374
审稿时长
1 months
期刊介绍: Renal Failure primarily concentrates on acute renal injury and its consequence, but also addresses advances in the fields of chronic renal failure, hypertension, and renal transplantation. Bringing together both clinical and experimental aspects of renal failure, this publication presents timely, practical information on pathology and pathophysiology of acute renal failure; nephrotoxicity of drugs and other substances; prevention, treatment, and therapy of renal failure; renal failure in association with transplantation, hypertension, and diabetes mellitus.
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