title: Detection of patients at high risk for non-occlusive mesenteric ischemia in hemodialysis.
abstract: BACKGROUND
  Nonocclusive mesenteric ischemia (NOMI) is an emerging condition in hemodialysis (HD) patients not widely studied.
  
  
  METHODS
  A retrospective study was conducted between 2003 and 2011. NOMI cases were recorded, and demographic, clinical, biochemical, and HD parameters were collected. This group was compared with a control group (n = 93). Risk factors, prognosis, and survival were analyzed.
  
  
  RESULTS
  There were 57 episodes of NOMI (incidence, 2.29 episodes per 100 patients/y). Cecum was the most frequently affected segment. Nineteen patients (33%) underwent surgery. Twenty-six patients (59%) did not survive the acute episode. Cecal damage was the only protective factor associated with mortality (relative risk [RR], 0.712; P = 0.044). The incidence of NOMI was related to erythropoietin resistance index, diabetes mellitus, and longer time on HD compared with control group (RR, 6.92, P = 0.009; RR, 9.98, P = 0.005; and RR, 1.017, P < 0.001, respectively). Mortality in survival NOMI patients was higher at 4-y follow-up compared with that in the control group (log-rank, 15.5; P < 0.0001).
  
  
  CONCLUSIONS
  NOMI is associated with erythropoietin resistance index, diabetes mellitus, and longer time on HD. Hypotension must be avoided in these high-risk patients to prevent NOMI.
authors.affiliation: Nephrology Department, Hospital Gregorio Marañón, Madrid, Spain. borjaqg@gmail.com
authors.forename: Borja
authors.initials: B
authors.lastname: Quiroga
authors.forename: Eduardo
authors.initials: E
authors.lastname: Verde
authors.forename: Soraya
authors.initials: S
authors.lastname: Abad
authors.forename: Almudena
authors.initials: A
authors.lastname: Vega
authors.forename: Marian
authors.initials: M
authors.lastname: Goicoechea
authors.forename: Javier
authors.initials: J
authors.lastname: Reque
authors.forename: Juan M
authors.initials: JM
authors.lastname: López-Gómez
authors.forename: José
authors.initials: J
authors.lastname: Luño
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007511:Ischemia / Q000209:etiology* / Q000401:mortality; D016015:Logistic Models; D008297:Male; D065666:Mesenteric Ischemia; D008875:Middle Aged; D012008:Recurrence; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D014652:Vascular Diseases / Q000209:etiology* / Q000401:mortality