6. Association Between Left Ventricular Ejection Fraction and Intradialytic Hypotension in End-Stage Chronic Kidney Disease on Hemodialysis at Prof. dr. R.D. Kandou Hospital

Abstract

Background: Intradialytic hypotension (IDH) is common complication during hemodialysis which increasing morbidity and mortality. The etiology of IDH is multifactorial, involving patient's demographic, dialysis process itself, and comorbid including cardiovascular disease. Left ventricular ejection fraction (LVEF) is a measurement of the amount of blood the left ventricle pumps with each heartbeat and holds an important role in cardiovascular response to low intravascular volume during hemodialysis. Objective: To investigate the association between LVEF and IDH in End-Stage Chronic Kidney Disease (ESCKD) on hemodialysis patients. Method: 70 ESCKD patients with regular hemodialysis for more than three months at Prof. Dr. R.D. Kandou hospital was investigated on September 2022 - November 2022. This cross sectional study defined intradialytic hypotension as > 20 mmHg decrease in systolic blood pressure (SBP) during hemodialysis. We analyze the data using Wilcoxon and Chi Square test with significant result (p < 0.05). Results: 70 patients included in this study consist of 42 male (60%) and 28 female (40%). The mean age is 54.69 + 9.617 years old with mean LVEF is 52.4 + 13.79%. There was significant result in comparison between systolic and diastolic pre and intradialytic (p < 0.001). IDH presented in 37 patients out of 70 patients. LVEF was found to be associated with IDH (p = 0.028) and patients with LVEF <50% was found more likely to develop IDH (OR = 3.37). Conclusion: LVEF was found to be associated with intradialytic hypotension and patients with LVEF <50% are 3.37 times more likely to develop intradialytic hypotension.