- 作者：Borja Quiroga ; MD ; borjaqg@gmail.com ; Eduardo Verde ; MD ; Soraya Abad ; MD ; Almudena Vega ; PhD ; Marian Goicoechea ; PhD ; Javier Reque ; MD ; Juan M. Ló ; pez-Gó ; mez ; PhD ; José ; Luñ ; o ; PhD
- 关键词：Hemodialysis ; Hypotension ; Nonocclusive mesenteric ischemia ; Survival
- 刊名：Journal of Surgical Research
- 出版年：2013
- 出版时间：March, 2013
- 年：2013
- 卷：180
- 期：1
- 页码：51-55
- 全文大小：245 K
Background
Nonocclusive mesenteric ischemia (NOMI) is an emerging condition in hemodialysis (HD) patients not widely studied.Materials and methods
A retrospective study was conducted between 2003 and 2011. NOMI cases were recorded, and demographic, clinical, biochemical, and HD parameters were collected. This group was compared with a control group (n = 93). Risk factors, prognosis, and survival were analyzed.
Results
There were 57 episodes of NOMI (incidence, 2.29 episodes per 100 patients/y). Cecum was the most frequently affected segment. Nineteen patients (33 % ) underwent surgery. Twenty-six patients (59 % ) did not survive the acute episode. Cecal damage was the only protective factor associated with mortality (relative risk [RR], 0.712; P = 0.044). The incidence of NOMI was related to erythropoietin resistance index, diabetes mellitus, and longer time on HD compared with control group (RR, 6.92, P = 0.009; RR, 9.98, P = 0.005; and RR, 1.017, P < 0.001, respectively). Mortality in survival NOMI patients was?higher at 4-y follow-up compared with that in the control group (log-rank, 15.5; P?<?0.0001).
Conclusions
NOMI is associated with erythropoietin resistance index, diabetes mellitus, and longer time on HD. Hypotension must be avoided in these high-risk patients to prevent NOMI.