title: Hypoalbuminemia is an important risk factor of hypotension during hemodialysis.
abstract: Hypotension during hemodialysis (HD) is an important problem in patients on HD. To investigate the risk factors that contribute to the hypotension during HD, we compared background factors of hypotensive (HP) patients during HD. Among 58 patients undergoing HD in Tamura Memorial Hospital, 12 patients could not continue full HD because of hypotension. We compared the data of ultrafiltration volume, cardiothoracic ratio (CTR), total protein (TP), serum albumin, blood urea nitrogen (BUN), serum creatinine, total cholesterol (TC), hemoglobin (Hb), blood glucose (BS), brain natriuretic peptide (BNP), and cardiac function between HP patients (HP group; n=12) and sex- and age-matched control patients (NP group; n=12). There were no significant differences of age, sex, and duration of HD between the 2 groups. Cardiothoracic ratio is bigger and BNP is higher in the HP group compared with the NP group (CTR: HP 55.8+/-2.9% vs. NP 47.7+/-1.1%, p=0.0165; BNP: HP 602+/-171 vs. NP 147+/-38, p=0.0167). Serum albumin in the HP group is significantly lower compared with the NP group (HP 3.2+/-0.1 g/dL vs. NP 3.5+/-0.1 g/dL, p=0.0130). However, there were no significant differences of ultrafiltration rate (UFR), BS, TC, Hb, and cardiac function between the 2 groups. There is a significant negative correlation between changes of systolic blood pressure (delta systolic blood pressure) and serum albumin in these patients (r=-0.598, p=0.0016). From these data, we conclude that hypoalbuminemia is a major risk factor of hypotension during HD.
authors.affiliation: Department of Nephrology, Saitama Medical School, Saitama, Japan. nakamo_h@saitama-med.ac.jp
authors.forename: Hidetomo
authors.initials: H
authors.lastname: Nakamoto
authors.forename: Nobuko
authors.initials: N
authors.lastname: Honda
authors.forename: Taku
authors.initials: T
authors.lastname: Mimura
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Suzuki
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D001806:Blood Urea Nitrogen; D002784:Cholesterol / Q000097:blood; D003404:Creatinine / Q000097:blood; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D034141:Hypoalbuminemia / Q000097:blood / Q000150:complications*; D007022:Hypotension / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy*; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011379:Prognosis; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism*; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D012709:Serum Albumin; D020097:Natriuretic Peptide, Brain; D002784:Cholesterol; D003404:Creatinine