Tisler et al. [1] published their findings about patients' survival suffering from intradialytic hypotension (IDH). To our knowledge this is the first study to have defined IDH with these criteria. Although up to now there has not been a consensus on IDH definition, some past issues use different definitions. Begin et al. [2] selected their patients when they represented IDH in 30% of haemodialysis sessions. Hoeben et al. [3] defined IDH as at least three episodes of a decrease in systolic blood pressure (by at least 20 mm Hg to <100 mm Hg) accompanied by symptoms (dizziness, blurred vision, nausea, vomiting, cramps, or fatigue) in 50% of HD treatments over 1 month. Like another article published by these authors [4], Barnas et al. [5] defined IDH as a dialysis-induced fall in mean arterial pressure to <65 mmHg in >25% of the dialysis sessions in the previous 2 months. However, Tisler et al. characterized their frequent IDH patients with the occurrence of 10 or more hypotension episodes during the run-in time.
This could have an effect on the number of patients who have divided in three groups and increase number of patients in frequent IDH group. So some patients have been noted as frequent IDH who are not really suffering from this problem as previously defined. We think regarding this issue that if authors modify their definition, the number of patients who are categorized as frequent IDH would decrease and it would affect the final results.
Conflict of interest statement. None declared.
Nephrology Department Emam Hossein Hospital Tehran Iran Email: rezab{at}medscape.com
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