title: Hemodialysis immediately after cardiac catheterization is a risk factor for intradialytic hypotension.
abstract: Many hemodialysis clinicians have noticed that patients frequently develop intradialytic hypotension (IDH) immediately after cardiac catheterization (CC). However, precise data about the incidence of IDH immediately after CC are scarce. This study involved a single-center, retrospective, cross-sectional design. We reviewed the medical records of all HD patients who underwent CC between January 2009 and March 2012 at Hiroshima Prefectural Hospital. IDH was defined as a fall of systolic blood pressure of more than 20 mm Hg or a fall of mean blood pressure of more than 10 mm Hg, with symptoms according to the K/DOQI criteria. Data on a total of 112 patients were obtained: 64 patients commenced HD immediately after CC (IA group) and 48 patients underwent HD on the day after CC (ND group). The overall incidence of IDH was 34% (38/112). The incidence of IDH was significantly higher in the IA group than in the ND group (27/64, 42% vs. 11/48, 23%; P < 0.05). Multivariate logistic regression analysis showed that IA (odds ratio, 5.39; 95% confidence interval, 1.76 to 16.49; P < 0.01), coronary stenosis (odds ratio, 4.16; 95% confidence interval, 1.49 to 11.64; P < 0.05) were independently associated with IDH. This study revealed that HD immediately after CC is associated with a higher incidence of IDH. Clinicians should consider that HD following CC be scheduled for the next day, especially in patients with coronary stenosis.
authors.affiliation: Department of Nephrology, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Taisuke
authors.initials: T
authors.lastname: Irifuku
authors.affiliation: Centre for Kidney Diseases, Hiroshima Prefectural Hospital, Hiroshima, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Naito
authors.affiliation: Centre for Kidney Diseases, Hiroshima Prefectural Hospital, Hiroshima, Japan.
authors.forename: Takahiko
authors.initials: T
authors.lastname: Ogawa
authors.affiliation: Centre for Kidney Diseases, Hiroshima Prefectural Hospital, Hiroshima, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Shimizu
authors.affiliation: Centre for Kidney Diseases, Hiroshima Prefectural Hospital, Hiroshima, Japan.
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Maeoka
authors.affiliation: Department of Nephrology, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Masaki
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D006328:Cardiac Catheterization / Q000379:methods*; D023921:Coronary Stenosis / Q000150:complications*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007022:Hypotension / Q000453:epidemiology / Q000209:etiology*; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
keywords: Cardiac catheterization; Coronary stenosis; Hemodialysis; Intradialytic hypotension; Myocardial stunning