Loading…
Intradialytic Hypotension and Cardiac Arrhythmias in Patients Undergoing Maintenance Hemodialysis: Results from the Monitoring in Dialysis Study
Patients receiving maintenance hemodialysis (HD) have a high incidence of cardiac events, including arrhythmia and sudden death. Intradialytic hypotension (IDH) is a common complication of HD and is associated with development of reduced myocardial perfusion, a potential risk factor for arrhythmia....
Saved in:
Published in: | Clinical journal of the American Society of Nephrology 2020-06, Vol.15 (6), p.805-812 |
---|---|
Main Authors: | , , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites |
Online Access: | Get full text |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
cited_by | |
---|---|
cites | cdi_FETCH-LOGICAL-c303t-2d374d16da6cfe7e279ca07fd104cd8543353437a3ee113162719d2b949558913 |
container_end_page | 812 |
container_issue | 6 |
container_start_page | 805 |
container_title | Clinical journal of the American Society of Nephrology |
container_volume | 15 |
creator | Mc Causland, Finnian R Tumlin, Jim A Roy-Chaudhury, Prabir Koplan, Bruce A Costea, Alexandru I Kher, Vijay Williamson, Don Pokhariyal, Saurabh Charytan, David M |
description | Patients receiving maintenance hemodialysis (HD) have a high incidence of cardiac events, including arrhythmia and sudden death. Intradialytic hypotension (IDH) is a common complication of HD and is associated with development of reduced myocardial perfusion, a potential risk factor for arrhythmia.
We analyzed data from the Monitoring in Dialysis study, which used implantable loop recorders to detect and continuously monitor electrocardiographic data from patients on maintenance HD (
=66 from the United States and India) over a 6-month period (
=4720 sessions). Negative binomial mixed effects regression was used to test the association of IDH
(decline in systolic BP >20 mm Hg from predialysis systolic BP) and IDH
(decline in systolic BP 0-20 mm Hg from predialysis systolic BP) with clinically significant arrhythmia (bradycardia≤40 bpm for ≥6 seconds, asystole≥3 seconds, ventricular tachycardia ≥130 bpm for ≥30 seconds, or patient-marked events) during HD.
The median age of participants was 58 (25th-75th percentile, 49-66) years; 70% were male; and 65% were from the United States. IDH occurred in 2251 (48%) of the 4720 HD sessions analyzed, whereas IDH
occurred during 1773 sessions (38%). The number of sessions complicated by least one intradialytic clinically significant arrhythmia was 27 (1.2%) where IDH
occurred and 15 (0.8%) where IDH
occurred. Participants who experienced IDH
(versus not) had a nine-fold greater rate of developing an intradialytic clinically significant arrhythmia (incidence rate ratio, 9.4; 95% confidence interval, 3.0 to 29.4), whereas IDH
was associated with a seven-fold higher rate (incidence rate ratio, 7.2; 95% confidence interval, 2.1 to 25.4).
IDH is common in patients on maintenance HD and is associated with a greater risk of developing intradialytic clinically significant arrhythmia. |
doi_str_mv | 10.2215/CJN.06810619 |
format | article |
fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7274298</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2400535970</sourcerecordid><originalsourceid>FETCH-LOGICAL-c303t-2d374d16da6cfe7e279ca07fd104cd8543353437a3ee113162719d2b949558913</originalsourceid><addsrcrecordid>eNpVkU1vEzEQhi0Eoh9w44x85ECKP9drDkhV-EhRCwioxM1y7dnEaNcOtrfS_gt-MhuaRnAaS_PMMyO_CD2j5IwxKl8tP346I01LSUP1A3RMpZQLTeSPh4e3oEfopJSfhAjBmXyMjjjjLZWtOEa_L2LN1gfbTzU4vJq2qUIsIUVso8dLm-eew-c5b6a6GYItOET8xdYAsRZ8HT3kdQpxja9siPOojQ7wCob011lCeY2_Qhn7Ge5yGnDdAL5KMdSUd1Oz7O0exN_q6Kcn6FFn-wJP9_UUXb9_9325Wlx-_nCxPL9cOE54XTDPlfC08bZxHShgSjtLVOcpEc63UnAuueDKcgBKOW2YotqzGy20lK2m_BS9ufNux5sBvIPdP_Rmm8Ng82SSDeb_Tgwbs063RjElmG5nwYu9IKdfI5RqhlAc9L2NkMZimCBEcqkVmdGXd6jLqZQM3WENJWYXoplDNPchzvjzf087wPep8T9gRZsF</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2400535970</pqid></control><display><type>article</type><title>Intradialytic Hypotension and Cardiac Arrhythmias in Patients Undergoing Maintenance Hemodialysis: Results from the Monitoring in Dialysis Study</title><source>PubMed Central Free</source><source>Highwire Press American Society of Nephrology</source><creator>Mc Causland, Finnian R ; Tumlin, Jim A ; Roy-Chaudhury, Prabir ; Koplan, Bruce A ; Costea, Alexandru I ; Kher, Vijay ; Williamson, Don ; Pokhariyal, Saurabh ; Charytan, David M</creator><creatorcontrib>Mc Causland, Finnian R ; Tumlin, Jim A ; Roy-Chaudhury, Prabir ; Koplan, Bruce A ; Costea, Alexandru I ; Kher, Vijay ; Williamson, Don ; Pokhariyal, Saurabh ; Charytan, David M ; MiD Investigators and Committees ; on behalf of the MiD Investigators and Committees</creatorcontrib><description>Patients receiving maintenance hemodialysis (HD) have a high incidence of cardiac events, including arrhythmia and sudden death. Intradialytic hypotension (IDH) is a common complication of HD and is associated with development of reduced myocardial perfusion, a potential risk factor for arrhythmia.
We analyzed data from the Monitoring in Dialysis study, which used implantable loop recorders to detect and continuously monitor electrocardiographic data from patients on maintenance HD (
=66 from the United States and India) over a 6-month period (
=4720 sessions). Negative binomial mixed effects regression was used to test the association of IDH
(decline in systolic BP >20 mm Hg from predialysis systolic BP) and IDH
(decline in systolic BP 0-20 mm Hg from predialysis systolic BP) with clinically significant arrhythmia (bradycardia≤40 bpm for ≥6 seconds, asystole≥3 seconds, ventricular tachycardia ≥130 bpm for ≥30 seconds, or patient-marked events) during HD.
The median age of participants was 58 (25th-75th percentile, 49-66) years; 70% were male; and 65% were from the United States. IDH occurred in 2251 (48%) of the 4720 HD sessions analyzed, whereas IDH
occurred during 1773 sessions (38%). The number of sessions complicated by least one intradialytic clinically significant arrhythmia was 27 (1.2%) where IDH
occurred and 15 (0.8%) where IDH
occurred. Participants who experienced IDH
(versus not) had a nine-fold greater rate of developing an intradialytic clinically significant arrhythmia (incidence rate ratio, 9.4; 95% confidence interval, 3.0 to 29.4), whereas IDH
was associated with a seven-fold higher rate (incidence rate ratio, 7.2; 95% confidence interval, 2.1 to 25.4).
IDH is common in patients on maintenance HD and is associated with a greater risk of developing intradialytic clinically significant arrhythmia.</description><identifier>ISSN: 1555-9041</identifier><identifier>EISSN: 1555-905X</identifier><identifier>DOI: 10.2215/CJN.06810619</identifier><identifier>PMID: 32381584</identifier><language>eng</language><publisher>United States: American Society of Nephrology</publisher><subject>Aged ; Arrhythmias, Cardiac - epidemiology ; Female ; Humans ; Hypotension - epidemiology ; Hypotension - etiology ; Hypotension - physiopathology ; Incidence ; India - epidemiology ; Male ; Middle Aged ; Original ; Prospective Studies ; Renal Dialysis - adverse effects ; Renal Dialysis - statistics & numerical data ; Renal Insufficiency - therapy ; United States - epidemiology</subject><ispartof>Clinical journal of the American Society of Nephrology, 2020-06, Vol.15 (6), p.805-812</ispartof><rights>Copyright © 2020 by the American Society of Nephrology.</rights><rights>Copyright © 2020 by the American Society of Nephrology 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c303t-2d374d16da6cfe7e279ca07fd104cd8543353437a3ee113162719d2b949558913</cites><orcidid>0000-0002-0299-0533</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7274298/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7274298/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,4011,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32381584$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mc Causland, Finnian R</creatorcontrib><creatorcontrib>Tumlin, Jim A</creatorcontrib><creatorcontrib>Roy-Chaudhury, Prabir</creatorcontrib><creatorcontrib>Koplan, Bruce A</creatorcontrib><creatorcontrib>Costea, Alexandru I</creatorcontrib><creatorcontrib>Kher, Vijay</creatorcontrib><creatorcontrib>Williamson, Don</creatorcontrib><creatorcontrib>Pokhariyal, Saurabh</creatorcontrib><creatorcontrib>Charytan, David M</creatorcontrib><creatorcontrib>MiD Investigators and Committees</creatorcontrib><creatorcontrib>on behalf of the MiD Investigators and Committees</creatorcontrib><title>Intradialytic Hypotension and Cardiac Arrhythmias in Patients Undergoing Maintenance Hemodialysis: Results from the Monitoring in Dialysis Study</title><title>Clinical journal of the American Society of Nephrology</title><addtitle>Clin J Am Soc Nephrol</addtitle><description>Patients receiving maintenance hemodialysis (HD) have a high incidence of cardiac events, including arrhythmia and sudden death. Intradialytic hypotension (IDH) is a common complication of HD and is associated with development of reduced myocardial perfusion, a potential risk factor for arrhythmia.
We analyzed data from the Monitoring in Dialysis study, which used implantable loop recorders to detect and continuously monitor electrocardiographic data from patients on maintenance HD (
=66 from the United States and India) over a 6-month period (
=4720 sessions). Negative binomial mixed effects regression was used to test the association of IDH
(decline in systolic BP >20 mm Hg from predialysis systolic BP) and IDH
(decline in systolic BP 0-20 mm Hg from predialysis systolic BP) with clinically significant arrhythmia (bradycardia≤40 bpm for ≥6 seconds, asystole≥3 seconds, ventricular tachycardia ≥130 bpm for ≥30 seconds, or patient-marked events) during HD.
The median age of participants was 58 (25th-75th percentile, 49-66) years; 70% were male; and 65% were from the United States. IDH occurred in 2251 (48%) of the 4720 HD sessions analyzed, whereas IDH
occurred during 1773 sessions (38%). The number of sessions complicated by least one intradialytic clinically significant arrhythmia was 27 (1.2%) where IDH
occurred and 15 (0.8%) where IDH
occurred. Participants who experienced IDH
(versus not) had a nine-fold greater rate of developing an intradialytic clinically significant arrhythmia (incidence rate ratio, 9.4; 95% confidence interval, 3.0 to 29.4), whereas IDH
was associated with a seven-fold higher rate (incidence rate ratio, 7.2; 95% confidence interval, 2.1 to 25.4).
IDH is common in patients on maintenance HD and is associated with a greater risk of developing intradialytic clinically significant arrhythmia.</description><subject>Aged</subject><subject>Arrhythmias, Cardiac - epidemiology</subject><subject>Female</subject><subject>Humans</subject><subject>Hypotension - epidemiology</subject><subject>Hypotension - etiology</subject><subject>Hypotension - physiopathology</subject><subject>Incidence</subject><subject>India - epidemiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Original</subject><subject>Prospective Studies</subject><subject>Renal Dialysis - adverse effects</subject><subject>Renal Dialysis - statistics & numerical data</subject><subject>Renal Insufficiency - therapy</subject><subject>United States - epidemiology</subject><issn>1555-9041</issn><issn>1555-905X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNpVkU1vEzEQhi0Eoh9w44x85ECKP9drDkhV-EhRCwioxM1y7dnEaNcOtrfS_gt-MhuaRnAaS_PMMyO_CD2j5IwxKl8tP346I01LSUP1A3RMpZQLTeSPh4e3oEfopJSfhAjBmXyMjjjjLZWtOEa_L2LN1gfbTzU4vJq2qUIsIUVso8dLm-eew-c5b6a6GYItOET8xdYAsRZ8HT3kdQpxja9siPOojQ7wCob011lCeY2_Qhn7Ge5yGnDdAL5KMdSUd1Oz7O0exN_q6Kcn6FFn-wJP9_UUXb9_9325Wlx-_nCxPL9cOE54XTDPlfC08bZxHShgSjtLVOcpEc63UnAuueDKcgBKOW2YotqzGy20lK2m_BS9ufNux5sBvIPdP_Rmm8Ng82SSDeb_Tgwbs063RjElmG5nwYu9IKdfI5RqhlAc9L2NkMZimCBEcqkVmdGXd6jLqZQM3WENJWYXoplDNPchzvjzf087wPep8T9gRZsF</recordid><startdate>20200608</startdate><enddate>20200608</enddate><creator>Mc Causland, Finnian R</creator><creator>Tumlin, Jim A</creator><creator>Roy-Chaudhury, Prabir</creator><creator>Koplan, Bruce A</creator><creator>Costea, Alexandru I</creator><creator>Kher, Vijay</creator><creator>Williamson, Don</creator><creator>Pokhariyal, Saurabh</creator><creator>Charytan, David M</creator><general>American Society of Nephrology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-0299-0533</orcidid></search><sort><creationdate>20200608</creationdate><title>Intradialytic Hypotension and Cardiac Arrhythmias in Patients Undergoing Maintenance Hemodialysis: Results from the Monitoring in Dialysis Study</title><author>Mc Causland, Finnian R ; Tumlin, Jim A ; Roy-Chaudhury, Prabir ; Koplan, Bruce A ; Costea, Alexandru I ; Kher, Vijay ; Williamson, Don ; Pokhariyal, Saurabh ; Charytan, David M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c303t-2d374d16da6cfe7e279ca07fd104cd8543353437a3ee113162719d2b949558913</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Arrhythmias, Cardiac - epidemiology</topic><topic>Female</topic><topic>Humans</topic><topic>Hypotension - epidemiology</topic><topic>Hypotension - etiology</topic><topic>Hypotension - physiopathology</topic><topic>Incidence</topic><topic>India - epidemiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Original</topic><topic>Prospective Studies</topic><topic>Renal Dialysis - adverse effects</topic><topic>Renal Dialysis - statistics & numerical data</topic><topic>Renal Insufficiency - therapy</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mc Causland, Finnian R</creatorcontrib><creatorcontrib>Tumlin, Jim A</creatorcontrib><creatorcontrib>Roy-Chaudhury, Prabir</creatorcontrib><creatorcontrib>Koplan, Bruce A</creatorcontrib><creatorcontrib>Costea, Alexandru I</creatorcontrib><creatorcontrib>Kher, Vijay</creatorcontrib><creatorcontrib>Williamson, Don</creatorcontrib><creatorcontrib>Pokhariyal, Saurabh</creatorcontrib><creatorcontrib>Charytan, David M</creatorcontrib><creatorcontrib>MiD Investigators and Committees</creatorcontrib><creatorcontrib>on behalf of the MiD Investigators and Committees</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical journal of the American Society of Nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mc Causland, Finnian R</au><au>Tumlin, Jim A</au><au>Roy-Chaudhury, Prabir</au><au>Koplan, Bruce A</au><au>Costea, Alexandru I</au><au>Kher, Vijay</au><au>Williamson, Don</au><au>Pokhariyal, Saurabh</au><au>Charytan, David M</au><aucorp>MiD Investigators and Committees</aucorp><aucorp>on behalf of the MiD Investigators and Committees</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intradialytic Hypotension and Cardiac Arrhythmias in Patients Undergoing Maintenance Hemodialysis: Results from the Monitoring in Dialysis Study</atitle><jtitle>Clinical journal of the American Society of Nephrology</jtitle><addtitle>Clin J Am Soc Nephrol</addtitle><date>2020-06-08</date><risdate>2020</risdate><volume>15</volume><issue>6</issue><spage>805</spage><epage>812</epage><pages>805-812</pages><issn>1555-9041</issn><eissn>1555-905X</eissn><abstract>Patients receiving maintenance hemodialysis (HD) have a high incidence of cardiac events, including arrhythmia and sudden death. Intradialytic hypotension (IDH) is a common complication of HD and is associated with development of reduced myocardial perfusion, a potential risk factor for arrhythmia.
We analyzed data from the Monitoring in Dialysis study, which used implantable loop recorders to detect and continuously monitor electrocardiographic data from patients on maintenance HD (
=66 from the United States and India) over a 6-month period (
=4720 sessions). Negative binomial mixed effects regression was used to test the association of IDH
(decline in systolic BP >20 mm Hg from predialysis systolic BP) and IDH
(decline in systolic BP 0-20 mm Hg from predialysis systolic BP) with clinically significant arrhythmia (bradycardia≤40 bpm for ≥6 seconds, asystole≥3 seconds, ventricular tachycardia ≥130 bpm for ≥30 seconds, or patient-marked events) during HD.
The median age of participants was 58 (25th-75th percentile, 49-66) years; 70% were male; and 65% were from the United States. IDH occurred in 2251 (48%) of the 4720 HD sessions analyzed, whereas IDH
occurred during 1773 sessions (38%). The number of sessions complicated by least one intradialytic clinically significant arrhythmia was 27 (1.2%) where IDH
occurred and 15 (0.8%) where IDH
occurred. Participants who experienced IDH
(versus not) had a nine-fold greater rate of developing an intradialytic clinically significant arrhythmia (incidence rate ratio, 9.4; 95% confidence interval, 3.0 to 29.4), whereas IDH
was associated with a seven-fold higher rate (incidence rate ratio, 7.2; 95% confidence interval, 2.1 to 25.4).
IDH is common in patients on maintenance HD and is associated with a greater risk of developing intradialytic clinically significant arrhythmia.</abstract><cop>United States</cop><pub>American Society of Nephrology</pub><pmid>32381584</pmid><doi>10.2215/CJN.06810619</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-0299-0533</orcidid><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1555-9041 |
ispartof | Clinical journal of the American Society of Nephrology, 2020-06, Vol.15 (6), p.805-812 |
issn | 1555-9041 1555-905X |
language | eng |
recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7274298 |
source | PubMed Central Free; Highwire Press American Society of Nephrology |
subjects | Aged Arrhythmias, Cardiac - epidemiology Female Humans Hypotension - epidemiology Hypotension - etiology Hypotension - physiopathology Incidence India - epidemiology Male Middle Aged Original Prospective Studies Renal Dialysis - adverse effects Renal Dialysis - statistics & numerical data Renal Insufficiency - therapy United States - epidemiology |
title | Intradialytic Hypotension and Cardiac Arrhythmias in Patients Undergoing Maintenance Hemodialysis: Results from the Monitoring in Dialysis Study |
url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-03T18%3A25%3A47IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Intradialytic%20Hypotension%20and%20Cardiac%20Arrhythmias%20in%20Patients%20Undergoing%20Maintenance%20Hemodialysis:%20Results%20from%20the%20Monitoring%20in%20Dialysis%20Study&rft.jtitle=Clinical%20journal%20of%20the%20American%20Society%20of%20Nephrology&rft.au=Mc%20Causland,%20Finnian%20R&rft.aucorp=MiD%20Investigators%20and%20Committees&rft.date=2020-06-08&rft.volume=15&rft.issue=6&rft.spage=805&rft.epage=812&rft.pages=805-812&rft.issn=1555-9041&rft.eissn=1555-905X&rft_id=info:doi/10.2215/CJN.06810619&rft_dat=%3Cproquest_pubme%3E2400535970%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c303t-2d374d16da6cfe7e279ca07fd104cd8543353437a3ee113162719d2b949558913%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2400535970&rft_id=info:pmid/32381584&rfr_iscdi=true |