Predictive significance of predialysis plasma osmolality for frequent intradialytic hypotension in elders on maintenance hemodialysis
ObjectiveTo explore the predictive value of predialysis plasma osmolality for frequent intradialytic hypotension (IDH) in elders on maintenance hemodialysis (MHD).MethodsAccording to whether or not there was frequent IDH, 301 MHD elders were assigned into two groups of control (n=257) and frequent I...
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| Format: | Article |
| Language: | zho |
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Editorial Department of Journal of Clinical Nephrology
2024-02-01
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| Series: | Linchuang shenzangbing zazhi |
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| Online Access: | http://www.lcszb.com/cn/article/doi/10.3969/j.issn.1671-2390.2024.02.005 |
| _version_ | 1797292782330576896 |
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| author | Xiao-hong Jiang Li-na Weng |
| author_facet | Xiao-hong Jiang Li-na Weng |
| author_sort | Xiao-hong Jiang |
| collection | DOAJ |
| description | ObjectiveTo explore the predictive value of predialysis plasma osmolality for frequent intradialytic hypotension (IDH) in elders on maintenance hemodialysis (MHD).MethodsAccording to whether or not there was frequent IDH, 301 MHD elders were assigned into two groups of control (n=257) and frequent IDH (n=44). General profiles, laboratory parameters and cardiac B-ultrasound examinations were recorded. The risk factors for frequent IDH were identified by multivariate Logistic regression. Receiver operating characteristic (ROC) curve was plotted for exploring the predictive efficacy of predialysis plasma osmolality for frequent IDH.ResultsAs compared with control group, ultrafiltration rate, parathyroid hormone (PTH) and predialysis plasma osmolality spiked obviously while hemoglobin, serum albumin (Alb), left ventricular ejection fraction (LVEF) and Kt/V declined markedly in frequent IDH group (all P<0.05). Multivariate analysis indicated that elevations of ultrafiltration rate (OR=1.24), PTH (OR=1.01) and predialysis plasma osmolality (OR=1.22) were risk factors for frequent IDH while elevations of Alb (OR=0.82) and LVEF (OR=0.73) were its protective factors. With an optimal cut-off value of 301.6 mOsm/(kg.H2O), area under the curve for predicting frequent IDH by predialysis plasma osmolality was 0.79 with a sensitivity of 58.5% and a specificity of 91.1%.ConclusionElders with an elevation of predialysis plasma osmolality are more susceptible to frequent IDH. They deserve a heightened attention. |
| first_indexed | 2024-03-07T20:01:34Z |
| format | Article |
| id | doaj.art-db26e038767443e1883f59a0a9129ae6 |
| institution | Directory Open Access Journal |
| issn | 1671-2390 |
| language | zho |
| last_indexed | 2024-03-07T20:01:34Z |
| publishDate | 2024-02-01 |
| publisher | Editorial Department of Journal of Clinical Nephrology |
| record_format | Article |
| series | Linchuang shenzangbing zazhi |
| spelling | doaj.art-db26e038767443e1883f59a0a9129ae62024-02-28T07:18:49ZzhoEditorial Department of Journal of Clinical NephrologyLinchuang shenzangbing zazhi1671-23902024-02-0124211612010.3969/j.issn.1671-2390.2024.02.00520230109Predictive significance of predialysis plasma osmolality for frequent intradialytic hypotension in elders on maintenance hemodialysisXiao-hong Jiang0Li-na Weng1Blood Purification Unit, Municipal People’s Hospital, Hai'an 226600, ChinaBlood Purification Unit, Municipal People’s Hospital, Hai'an 226600, ChinaObjectiveTo explore the predictive value of predialysis plasma osmolality for frequent intradialytic hypotension (IDH) in elders on maintenance hemodialysis (MHD).MethodsAccording to whether or not there was frequent IDH, 301 MHD elders were assigned into two groups of control (n=257) and frequent IDH (n=44). General profiles, laboratory parameters and cardiac B-ultrasound examinations were recorded. The risk factors for frequent IDH were identified by multivariate Logistic regression. Receiver operating characteristic (ROC) curve was plotted for exploring the predictive efficacy of predialysis plasma osmolality for frequent IDH.ResultsAs compared with control group, ultrafiltration rate, parathyroid hormone (PTH) and predialysis plasma osmolality spiked obviously while hemoglobin, serum albumin (Alb), left ventricular ejection fraction (LVEF) and Kt/V declined markedly in frequent IDH group (all P<0.05). Multivariate analysis indicated that elevations of ultrafiltration rate (OR=1.24), PTH (OR=1.01) and predialysis plasma osmolality (OR=1.22) were risk factors for frequent IDH while elevations of Alb (OR=0.82) and LVEF (OR=0.73) were its protective factors. With an optimal cut-off value of 301.6 mOsm/(kg.H2O), area under the curve for predicting frequent IDH by predialysis plasma osmolality was 0.79 with a sensitivity of 58.5% and a specificity of 91.1%.ConclusionElders with an elevation of predialysis plasma osmolality are more susceptible to frequent IDH. They deserve a heightened attention.http://www.lcszb.com/cn/article/doi/10.3969/j.issn.1671-2390.2024.02.005plasma osmolalityhemodialysisintradialytic hypotensionelder |
| spellingShingle | Xiao-hong Jiang Li-na Weng Predictive significance of predialysis plasma osmolality for frequent intradialytic hypotension in elders on maintenance hemodialysis Linchuang shenzangbing zazhi plasma osmolality hemodialysis intradialytic hypotension elder |
| title | Predictive significance of predialysis plasma osmolality for frequent intradialytic hypotension in elders on maintenance hemodialysis |
| title_full | Predictive significance of predialysis plasma osmolality for frequent intradialytic hypotension in elders on maintenance hemodialysis |
| title_fullStr | Predictive significance of predialysis plasma osmolality for frequent intradialytic hypotension in elders on maintenance hemodialysis |
| title_full_unstemmed | Predictive significance of predialysis plasma osmolality for frequent intradialytic hypotension in elders on maintenance hemodialysis |
| title_short | Predictive significance of predialysis plasma osmolality for frequent intradialytic hypotension in elders on maintenance hemodialysis |
| title_sort | predictive significance of predialysis plasma osmolality for frequent intradialytic hypotension in elders on maintenance hemodialysis |
| topic | plasma osmolality hemodialysis intradialytic hypotension elder |
| url | http://www.lcszb.com/cn/article/doi/10.3969/j.issn.1671-2390.2024.02.005 |
| work_keys_str_mv | AT xiaohongjiang predictivesignificanceofpredialysisplasmaosmolalityforfrequentintradialytichypotensionineldersonmaintenancehemodialysis AT linaweng predictivesignificanceofpredialysisplasmaosmolalityforfrequentintradialytichypotensionineldersonmaintenancehemodialysis |