Key result
Higher SEVR links to ~54% lower risk of major hemodialysis SBP drops per SD.
Why the study?
To investigate the predictive value of the central arterial waveform for intradialytic blood pressure changes during hemodialysis.
Does predialysis central arterial waveform (SEVR) predict intradialytic blood pressure decrease in hemodialysis patients?
Observational (n=152)
Yes
Does predialysis central arterial waveform (SEVR) predict intradialytic blood pressure decrease in hemodialysis patients?
Predialysis subendocardial viability ratio (SEVR) is an independent predictor of significant intradialytic blood pressure decrease, suggesting its utility as a complementary screening tool in hemodialysis patients.
Answers are grounded in this paper and cite their sources.
SEVR was associated with lower intradialytic hypotension risk in hemodialysis; hypothesis-generating and leaves open any screening role.
To investigate the predictive value of the central arterial waveform for intradialytic blood pressure (BP) change, a total of 152 hemodialysis patients (mean age 68 years) on a thrice-weekly hemodialysis schedule were enrolled, and at both the first and second session of the week, BP and central arterial waveform were measured every 30 min during hemodialysis. In both sessions, a 1-standard deviation increase in baseline subendocardial viability ratio (SEVR), an index of subendocardial perfusion, as well as in baseline systolic BP (SBP) was an independent predictor of maximum SBP decrease ≥ 30 mmHg during hemodialysis. When divided into four groups based on the respective median level of SEVR in the SBP ≥ median and SBP < median groups, intradialytic SBP change was different among the subgroups. Multiple logistic regression analysis revealed that, compared with the SBP < median; low SEVR group, the SBP < median; high SEVR group had lower risk, and the SBP ≥ median; low SEVR group had higher risk of SBP decrease ≥ 30 mmHg, but the risk did not differ from that in the SBP ≥ median; high SEVR group. Predialysis subendocardial perfusion evaluated by SEVR was associated with the maximum intradialytic BP decrease, and evaluation of the central arterial waveform could be used as complementary screening for intradialytic BP change.
No takes yet. Share an insight, caveat, or question.
Iwashima et al. (2024) conducted an observational in End-stage renal disease on hemodialysis (n=152). Baseline subendocardial viability ratio (SEVR) was evaluated on Maximum systolic blood pressure decrease ≥ 30 mmHg during hemodialysis (OR 0.46, 95% CI 0.23-0.83, p=<0.01). A 1-standard deviation increase in baseline subendocardial viability ratio was independently associated with a lower risk of a systolic blood pressure decrease of ≥30 mmHg during hemodialysis (OR 0.46).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: