Maintenance dialysis was associated with greater in-hospital morbidity and mortality among CMI-coded revascularization hospitalizations in the 2006-2020 National Inpatient Sample, though causation and optimal treatment timing cannot be established.
Maintenance dialysis accounted for a small fraction of CMI revascularization hospitalizations in the National Inpatient Sample.
Maintenance dialysis was associated with roughly double the adjusted odds of in-hospital mortality after CMI revascularization.
Maintenance dialysis was associated with higher odds of non-routine discharge and prolonged hospitalization.
Maintenance dialysis was associated with higher odds of several postoperative complications.
Hospital charges were higher in dialysis patients, while urinary tract infection odds were lower.
The data cannot distinguish stable from acute-on-chronic CMI, limiting interpretation as an elective cohort and causal inference.
This study used a large US national database of hospital stays from 2006 to 2020 to look at people who had procedures to restore blood flow to the intestines because of chronic mesenteric ischemia, a condition in which the arteries supplying the gut are narrowed. It compared patients who were on long-term dialysis for kidney failure with those who were not, using statistical matching to make the groups more similar. Of nearly 8,000 hospital stays, about 5% involved patients on dialysis. Patients on dialysis had worse outcomes in the hospital. Their odds of dying during the stay were nearly double, and they were more likely to need a blood transfusion, develop sepsis, pneumonia, blood clots in the veins, or multiorgan failure or shock. They were also more likely to have a longer stay, be discharged somewhere other than home, and have higher hospital charges (about $17,500 more). Urinary tract infections were less common, which may relate to dialysis patients often making little urine. This research suggests that dialysis status is an important marker of risk when considering these procedures. However, the database could not tell whether patients had stable chronic disease or a sudden worsening, so the results may not apply to planned procedures only. The study shows association, not cause, and does not determine the best timing or treatment; it supports carefully individualized assessment before surgery.
Kuo C, Chang L, Liao C, Yang D. (2026). In-Hospital Outcomes and Mortality After Revascularization for Chronic Mesenteric Ischemia by Maintenance Dialysis Status: A National Inpatient Sample Analysis, 2006-2020.. Journal of investigative surgery : the official journal of the Academy of Surgical Research. https://doi.org/10.1080/08941939.2026.2748718