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. Materials and methods A retrospective study was conducted between 2003 and 2011. NOMI cases were recorded, and demographic, clinical, biochemical, and HD parameters...

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Published in:The Journal of surgical research 2013-03, Vol.180 (1), p.51-55
Main Authors: Quiroga, Borja, MD, Verde, Eduardo, MD, Abad, Soraya, MD, Vega, Almudena, PhD, Goicoechea, Marian, PhD, Reque, Javier, MD, López-Gómez, Juan M., PhD, Luño, José, PhD
Format: Article
Language:English
Subjects:
Aged
Female
Hemodialysis
Humans
Hypotension
Ischemia - etiology
Ischemia - mortality
Logistic Models
Male
Mesenteric Ischemia
Middle Aged
Nonocclusive mesenteric ischemia
Recurrence
Renal Dialysis - adverse effects
Retrospective Studies
Risk Factors
Surgery
Survival
Vascular Diseases - etiology
Vascular Diseases - mortality
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Summary:Abstract Background Nonocclusive mesenteric ischemia (NOMI) is an emerging condition in hemodialysis (HD) patients not widely studied. Materials and 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  
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2012.10.008