Factors associated with mortality from non-occlusive mesenteric ischemia in dialysis patients

Chen Chao Yu, Heng Jung Hsu, I. Wen Wu, Chin Chan Lee, Chi Jen Tsai, Chia Chi Chou, Mai Szu Wu

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background.Among dialysis patients, acute mesenteric ischemia is mostly caused by non-occlusive mesenteric ischemia (NOMI). There is a very high mortality rate associated with this complication, but prognostic factors associated with NOMI are not well-known.Method.In this study, we retrospectively reviewed the records of dialysis patients to identify prognostic factors associated with mortality from NOMI. Overall, there were 541 patients on hemodialysis (HD) and 158 patients on peritoneal dialysis (PD) in our hospital from January 2007 to December 2008. Among these 699 patients, we diagnosed NOMI by surgical and/or radiological criteria. A total of 12 dialysis patients (9 on HD and 3 on PD) developed NOMI during the study period.Result.The incidence of NOMI was 1.04 per patient-year for all dialysis patients (0.95 for HD and 1.35 for PD patients). Most of the 12 patients had chronic hypotension (83.3, 1012). Four patients expired following development of NOMI. Our results showed that mortality was significantly higher in patients who were administered a cyclooxygenase (COX) inhibitor prior to ischemia. Hypobicarbonemia during NOMI, which might indicate the severity of hypoperfusion, is also associated with higher mortality. Conclusion.NOMI is rare in dialysis patients. COX inhibitor administration should be given with caution in long-term hypotensive dialysis patients.

Original languageEnglish
Pages (from-to)802-806
Number of pages5
JournalRenal Failure
Volume31
Issue number9
DOIs
Publication statusPublished - Oct 2009
Externally publishedYes

Keywords

  • Cyclooxygenase inhibitors
  • Dialysis
  • Hypotension
  • Mesenteric ischemia
  • Mortality

ASJC Scopus subject areas

  • Nephrology
  • Critical Care and Intensive Care Medicine

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