title: Intradialytic hypotension is associated with dialytic age in patients on chronic hemodialysis.
abstract: OBJECTIVE
  Intradialytic hypotension (IDH) is common in patients on chronic hemodialysis, but knowledge on determinants is still unclear. The present study aims at evaluating the association between IDH and dialytic age (DA) in patients on chronic hemodialysis.
  
  
  METHODS
  Between January 2012 and January 2013, 82 patients on chronic hemodialysis for at least 1 year were screened for inclusion in the present study. Of these, 14 were excluded because of advanced heart failure (n.9), history of alcohol/substance abuse (n.1), diagnosis of dementia (n.2), actual instability of clinical conditions requiring hospitalization (n.2). IDH was defined as a decrease in systolic blood pressure ≥20 mmHg or a decrease in mean arterial pressure (MAP) by 10 mmHg associated with clinical events and need for nursing interventions. The number of IDH episodes in 10 consecutive hemodialysis sessions was recorded for each patient. Linear and logistic regressions were adopted to assess the adjusted association between IDH and DA.
  
  
  RESULTS
  The mean DA was 92 ± 81. Eleven patients (16%) experienced IDH. DA was associated with IDH (OR = 1.01; 95% CI = 1.01-1.02; p = 0.048), after adjusting for potential confounders. DA was associated with the numbers of IDH events in the unadjusted model (B = 0.02; 95% CI = 0.01-0.03; p = 0.042), after adjusting for age and sex (B = 0.01; 95% CI = 0.01-0.03; p = 0.042) as well as in the multivariable model (B = 0.02; 95% CI = 0.01-0.05; p = 0.045).
  
  
  CONCLUSIONS
  DA is associated with an increased probability of IDH and with increased number of IHD events. Studies are needed to understand the underlying factors of such an association.
authors.affiliation: Hemodialysis Service, Department of Surgery, Catholic University of the Sacred Heart , Rome , Italy .
authors.forename: Maurizio
authors.initials: M
authors.lastname: Bossola
authors.forename: Alice
authors.initials: A
authors.lastname: Laudisio
authors.forename: Manuela
authors.initials: M
authors.lastname: Antocicco
authors.forename: Nicola
authors.initials: N
authors.lastname: Panocchia
authors.forename: Luigi
authors.initials: L
authors.lastname: Tazza
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Colloca
authors.forename: Matteo
authors.initials: M
authors.lastname: Tosato
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Zuccalà
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D006435:Renal Dialysis / Q000009:adverse effects*; D013997:Time Factors