Key result
Asymptomatic intradialytic hypotension significantly correlated with elevated postdialysis cardiac troponin I (r = 0.492, p < 0.05), which was associated with increased ACS and cardiac death at 2 years.
Why the study?
Intradialytic hypotension is a serious complication during hemodialysis in ESRD patients, but the effect of asymptomatic intradialytic hypotension on cardiac troponin I levels has not been definitively elucidated.
Does asymptomatic intradialytic hypotension increase cardiac troponin I levels and predict adverse outcomes in hemodialysis patients?
Cohort (n=70)
Does asymptomatic intradialytic hypotension increase cardiac troponin I levels and predict adverse outcomes in hemodialysis patients?
Answers are grounded in this paper and cite their sources.
Asymptomatic intradialytic hypotension is associated with elevated cardiac troponin I levels and increased risk of acute coronary syndrome and cardiac death in hemodialysis patients.
Background. Intradialytic hypotension (IDH) has been recognized as a serious and frequent complication during hemodialysis (HD) of end‐stage renal disease (ESRD) patients, but the effect of asymptomatic IDH on cardiac troponin I (cTnI) levels is not definitively elucidated. Methods. 70 asymptomatic HD patients with negative predialysis cTnI were included. They were on maintenance HD thrice weekly. All patients were monitored during the HD session for hemodynamic changes and symptoms related to IDH. Patients were followed for two years, and their outcomes are noted as an acute coronary syndrome (ACS), cardiac death, no ACS, noncardiac death, and kidney transplant. Results. Compared with the baseline blood pressure values, there was a drop in systolic blood pressure for all subjects, but according to the 2007 European Best Practice Guidelines on hemodynamic instability, asymptomatic IDH was defined in 27 (38.6%) patients. The results demonstrated a significant correlation (r = 0.492) (p < 0.05) between asymptomatic IDH and elevated postdialysis levels of cTnI. In 2‐year follow‐up of patients, ACS and cardiac death happened more in patients with elevated cTnI. Conclusion. The results of our study suggest that asymptomatic IDH affects cTnI levels. Given that cTnI is a marker of myocardial damage and a predictor of cardiovascular mortality in ESRD patients, these findings recommend that considering the asymptomatic decrease in blood pressure levels during HD is very important and critical.
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Alirezaei et al. (2022) conducted a cohort in End-stage renal disease on hemodialysis (n=70). Asymptomatic intradialytic hypotension vs. No asymptomatic intradialytic hypotension was evaluated on Elevated postdialysis levels of cardiac troponin I (r = 0.492, p=<0.05). Asymptomatic intradialytic hypotension significantly correlated with elevated postdialysis cardiac troponin I (r = 0.492, p < 0.05), which was associated with increased ACS and cardiac death at 2 years.
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