Risk Factors for Intradialytic Hypotension during Hemodialysis among the End-stage Renal Disease Patients with Pre-existing Autonomic Dysfunction

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Thanawat Vongchaiudomchoke

Abstract

Background: Hemodialysis patients who have had pre-existing autonomic dysfunction are at risk for intradialytic hypotension (IDH).
Objective: To study the prevalence and risk factors of intradialytic hypotension in hemodialytic patients with autonomic dysfunction.
Material and method: Retrospective chart of 48 hemodialytic patients with autonomic dysfunction verified by the heart rate variation during deep breathing test in Lampang Hospital between May - August 2019 were reviewed. The patients were categorized into two groups; patients with IDH according to Nadir 90 criteria (N=18) and patients without IDH (N=30). Baseline characteristics and dialysis profiles were statistically compared between groups and the risk factors for intradialytic
hypotension were determined by regression analysis.
Results: IDH group had higher age (65.7±9.8 vs 58.3±12.6 years, p=0.038), lower percentage of patients receiving hydralazine medication (38.9% vs 73.3%, p=0.032), lower predialysis systolic blood pressure (124.1±22.3 vs 140.3±17.7 mmHg, p=0.008) and lower serum albumin (3.5±0.5 vs 3.8±0.2 g/dl, p=0.009) compared to the non-IDH group. The multivariate regression analysis revealed that hypoalbuminemia was a significant risk factor (RR 2.88, 95% CI 1.01-8.25, p=0.049).
Conclusion: The prevalence of IDH was 37.5% among the patients with pre-existing autonomic dysfunction. Serum albumin less than 3.5 g/dl increased the risk of IDH.

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How to Cite
Vongchaiudomchoke, T. (2020). Risk Factors for Intradialytic Hypotension during Hemodialysis among the End-stage Renal Disease Patients with Pre-existing Autonomic Dysfunction. Lampang Medical Journal, 40(2), 50-59. Retrieved from https://he01.tci-thaijo.org/index.php/LMJ/article/view/217535
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Original Article

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