The Prevalence of Intradialytic Hypotension in Patients on Conventional Hemodialysis: A Systematic Review with Meta-Analysis
Background: Intradialytic hypotension (IDH) is considered to be a frequent complication of hemodialysis (HD) and is associated with symptom burden, increased incidence of access failure, cardiovascular events, and higher mortality. This systematic literature review aims to analyse studies that inves...
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| Veröffentlicht in: | American journal of nephrology 2019-06, Vol.49 (6), p.497-506 |
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| container_title | American journal of nephrology |
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| creator | Kuipers, Johanna Verboom, Loes M. Ipema, Karin J.R. Paans, Wolter Krijnen, Wim P. Gaillard, Carlo A.J.M. Westerhuis, Ralf Franssen, Casper F.M. |
| description | Background: Intradialytic hypotension (IDH) is considered to be a frequent complication of hemodialysis (HD) and is associated with symptom burden, increased incidence of access failure, cardiovascular events, and higher mortality. This systematic literature review aims to analyse studies that investigated the prevalence of IDH. A complicating factor herein is that many different definitions of IDH are used in literature. Methods: A systematic literature search from databases, Medline, Cinahl, EMBASE, and the Cochrane library to identify studies reporting on the actual prevalence of IDH was conducted. Studies were categorized by the type of definition used for the prevalence of IDH. A meta-analysis of the prevalence of IDH was performed. Results: In a meta-analysis comprising 4 studies including 1,694 patients and 4 studies including 13,189 patients, the prevalence of HD sessions complicated by IDH was 10.1 and 11.6% for the European Best Practice Guideline (EBPG) definition and the Nadir |
| doi_str_mv | 10.1159/000500877 |
| format | Article |
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This systematic literature review aims to analyse studies that investigated the prevalence of IDH. A complicating factor herein is that many different definitions of IDH are used in literature. Methods: A systematic literature search from databases, Medline, Cinahl, EMBASE, and the Cochrane library to identify studies reporting on the actual prevalence of IDH was conducted. Studies were categorized by the type of definition used for the prevalence of IDH. A meta-analysis of the prevalence of IDH was performed. Results: In a meta-analysis comprising 4 studies including 1,694 patients and 4 studies including 13,189 patients, the prevalence of HD sessions complicated by IDH was 10.1 and 11.6% for the European Best Practice Guideline (EBPG) definition and the Nadir <90 definition, respectively. The proportion of patients with frequent IDH could not reliably be established because of the wide range in cutoff values that were used to identify patients with frequent IDH. There was a large variety in the prevalence of symptoms and interventions. Major risk factors associated with IDH across studies were diabetes, a higher interdialytic weight gain, female gender, and lower body weight. Conclusion: Our meta-analysis suggests that the prevalence of IDH is lower than 12% for both the EBPG and the Nadir <90 definition which is much lower than stated in most reviews.</description><identifier>ISSN: 0250-8095</identifier><identifier>EISSN: 1421-9670</identifier><identifier>DOI: 10.1159/000500877</identifier><identifier>PMID: 31129661</identifier><language>eng</language><publisher>Basel, Switzerland: S. Karger AG</publisher><subject>Complications and side effects ; Hemodialysis ; Hypotension ; Patient-Oriented, Translational Research ; Patient-Oriented, Translational Research: Research Article ; Risk factors ; Statistics</subject><ispartof>American journal of nephrology, 2019-06, Vol.49 (6), p.497-506</ispartof><rights>2019 The Author(s) Published by S. Karger AG, Basel</rights><rights>2019 The Author(s) Published by S. Karger AG, Basel.</rights><rights>COPYRIGHT 2019 S. Karger AG</rights><rights>Copyright © 2019 by S. Karger AG, Basel 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c522t-9db3d875fb846c9726f58fc1574ce5be21e1e8425246b48c9871eb59bd2d6b1b3</citedby><orcidid>0000-0001-5835-6702</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,2427,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31129661$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kuipers, Johanna</creatorcontrib><creatorcontrib>Verboom, Loes M.</creatorcontrib><creatorcontrib>Ipema, Karin J.R.</creatorcontrib><creatorcontrib>Paans, Wolter</creatorcontrib><creatorcontrib>Krijnen, Wim P.</creatorcontrib><creatorcontrib>Gaillard, Carlo A.J.M.</creatorcontrib><creatorcontrib>Westerhuis, Ralf</creatorcontrib><creatorcontrib>Franssen, Casper F.M.</creatorcontrib><title>The Prevalence of Intradialytic Hypotension in Patients on Conventional Hemodialysis: A Systematic Review with Meta-Analysis</title><title>American journal of nephrology</title><addtitle>Am J Nephrol</addtitle><description>Background: Intradialytic hypotension (IDH) is considered to be a frequent complication of hemodialysis (HD) and is associated with symptom burden, increased incidence of access failure, cardiovascular events, and higher mortality. This systematic literature review aims to analyse studies that investigated the prevalence of IDH. A complicating factor herein is that many different definitions of IDH are used in literature. Methods: A systematic literature search from databases, Medline, Cinahl, EMBASE, and the Cochrane library to identify studies reporting on the actual prevalence of IDH was conducted. Studies were categorized by the type of definition used for the prevalence of IDH. A meta-analysis of the prevalence of IDH was performed. Results: In a meta-analysis comprising 4 studies including 1,694 patients and 4 studies including 13,189 patients, the prevalence of HD sessions complicated by IDH was 10.1 and 11.6% for the European Best Practice Guideline (EBPG) definition and the Nadir <90 definition, respectively. The proportion of patients with frequent IDH could not reliably be established because of the wide range in cutoff values that were used to identify patients with frequent IDH. There was a large variety in the prevalence of symptoms and interventions. Major risk factors associated with IDH across studies were diabetes, a higher interdialytic weight gain, female gender, and lower body weight. Conclusion: Our meta-analysis suggests that the prevalence of IDH is lower than 12% for both the EBPG and the Nadir <90 definition which is much lower than stated in most reviews.</description><subject>Complications and side effects</subject><subject>Hemodialysis</subject><subject>Hypotension</subject><subject>Patient-Oriented, Translational Research</subject><subject>Patient-Oriented, Translational Research: Research Article</subject><subject>Risk factors</subject><subject>Statistics</subject><issn>0250-8095</issn><issn>1421-9670</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>M--</sourceid><recordid>eNptkt2L1DAUxYso7rj64LtIQBB96JqkTdrsg1AGdVZWXXR9Dml6OxNtk7HJzDLgH29qx3EHljzk4_7uCfdwkuQpwWeEMPEGY8wwLoviXjIjOSWp4AW-n8wwZTgtsWAnySPvf2BMaImLh8lJRggVnJNZ8vt6BehqgK3qwGpArkUXNgyqMarbBaPRYrd2Aaw3ziJj0ZUKBmzwKF7nzm7jOVZUhxbQu79N3vhzVKFvOx-gV6PEV9gauEE3JqzQJwgqrezEPU4etKrz8GS_nybf37-7ni_Syy8fLubVZaoZpSEVTZ01ZcHausy5FgXlLStbTViRa2A1UAIEypwymvM6L7UoCwI1E3VDG16TOjtN3k66603dQ6NhnLCT68H0athJp4w8rlizkku3lZzjnPIsCrzaCwzu1wZ8kL3xGrpOWXAbLynNKMGZYEVEX0zoMjoqjW1dVNQjLiueYZHlhItInd1BxdVAb7Sz0Jr4ftTw8lbDClQXVt51m9F9fwy-nkA9OO8HaA9jEizHtMhDWiL7_LYvB_JfPP4P81MNSxgOQPXx8yQh100bqWd3Uvtf_gCrz88v</recordid><startdate>20190601</startdate><enddate>20190601</enddate><creator>Kuipers, Johanna</creator><creator>Verboom, Loes M.</creator><creator>Ipema, Karin J.R.</creator><creator>Paans, Wolter</creator><creator>Krijnen, Wim P.</creator><creator>Gaillard, Carlo A.J.M.</creator><creator>Westerhuis, Ralf</creator><creator>Franssen, Casper F.M.</creator><general>S. Karger AG</general><scope>M--</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-5835-6702</orcidid></search><sort><creationdate>20190601</creationdate><title>The Prevalence of Intradialytic Hypotension in Patients on Conventional Hemodialysis: A Systematic Review with Meta-Analysis</title><author>Kuipers, Johanna ; Verboom, Loes M. ; Ipema, Karin J.R. ; Paans, Wolter ; Krijnen, Wim P. ; Gaillard, Carlo A.J.M. ; Westerhuis, Ralf ; Franssen, Casper F.M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c522t-9db3d875fb846c9726f58fc1574ce5be21e1e8425246b48c9871eb59bd2d6b1b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Complications and side effects</topic><topic>Hemodialysis</topic><topic>Hypotension</topic><topic>Patient-Oriented, Translational Research</topic><topic>Patient-Oriented, Translational Research: Research Article</topic><topic>Risk factors</topic><topic>Statistics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kuipers, Johanna</creatorcontrib><creatorcontrib>Verboom, Loes M.</creatorcontrib><creatorcontrib>Ipema, Karin J.R.</creatorcontrib><creatorcontrib>Paans, Wolter</creatorcontrib><creatorcontrib>Krijnen, Wim P.</creatorcontrib><creatorcontrib>Gaillard, Carlo A.J.M.</creatorcontrib><creatorcontrib>Westerhuis, Ralf</creatorcontrib><creatorcontrib>Franssen, Casper F.M.</creatorcontrib><collection>Karger Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kuipers, Johanna</au><au>Verboom, Loes M.</au><au>Ipema, Karin J.R.</au><au>Paans, Wolter</au><au>Krijnen, Wim P.</au><au>Gaillard, Carlo A.J.M.</au><au>Westerhuis, Ralf</au><au>Franssen, Casper F.M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Prevalence of Intradialytic Hypotension in Patients on Conventional Hemodialysis: A Systematic Review with Meta-Analysis</atitle><jtitle>American journal of nephrology</jtitle><addtitle>Am J Nephrol</addtitle><date>2019-06-01</date><risdate>2019</risdate><volume>49</volume><issue>6</issue><spage>497</spage><epage>506</epage><pages>497-506</pages><issn>0250-8095</issn><eissn>1421-9670</eissn><abstract>Background: Intradialytic hypotension (IDH) is considered to be a frequent complication of hemodialysis (HD) and is associated with symptom burden, increased incidence of access failure, cardiovascular events, and higher mortality. This systematic literature review aims to analyse studies that investigated the prevalence of IDH. A complicating factor herein is that many different definitions of IDH are used in literature. Methods: A systematic literature search from databases, Medline, Cinahl, EMBASE, and the Cochrane library to identify studies reporting on the actual prevalence of IDH was conducted. Studies were categorized by the type of definition used for the prevalence of IDH. A meta-analysis of the prevalence of IDH was performed. Results: In a meta-analysis comprising 4 studies including 1,694 patients and 4 studies including 13,189 patients, the prevalence of HD sessions complicated by IDH was 10.1 and 11.6% for the European Best Practice Guideline (EBPG) definition and the Nadir <90 definition, respectively. The proportion of patients with frequent IDH could not reliably be established because of the wide range in cutoff values that were used to identify patients with frequent IDH. There was a large variety in the prevalence of symptoms and interventions. Major risk factors associated with IDH across studies were diabetes, a higher interdialytic weight gain, female gender, and lower body weight. Conclusion: Our meta-analysis suggests that the prevalence of IDH is lower than 12% for both the EBPG and the Nadir <90 definition which is much lower than stated in most reviews.</abstract><cop>Basel, Switzerland</cop><pub>S. Karger AG</pub><pmid>31129661</pmid><doi>10.1159/000500877</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-5835-6702</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Complications and side effects Hemodialysis Hypotension Patient-Oriented, Translational Research Patient-Oriented, Translational Research: Research Article Risk factors Statistics |
| title | The Prevalence of Intradialytic Hypotension in Patients on Conventional Hemodialysis: A Systematic Review with Meta-Analysis |
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