{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T13:38:03Z","timestamp":1787060283716,"version":"build-2736575974"},"reference-count":12,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Background<\/jats:title>\n Patients with end-stage renal disease (ESRD) are at highly susceptible to hemodynamic instability during anesthesia induction. However, data specific to this population remain limited.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective cohort study included 635 adult patients with ESRD who underwent non-cardiac surgery under general anesthesia between 2012 and 2022. Post-induction hypotension was defined as a\u2009\u2265\u200930% reduction in mean arterial pressure (MAP) from baseline within 20 minutes after induction, requiring vasopressor support. Multivariable logistic regression was performed to identify independent predictors.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The incidence of post-induction hypotension was 44.1% (95% confidence interval (CI), 40.2\u201347.9). Independent predictors included age\u2009>\u200965 years, chronic oral antidiabetic therapy, higher propofol dose, rapid sequence induction, and emergency surgery. The incidence of hypotension peaked at 20 min after induction. Dialysis-related variables were not significantly associated with hypotension.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Post-induction hypotension is common in patients with ESRD and associated with advanced age, chronic antidiabetic therapy, higher propofol dose, rapid sequence induction, and emergency surgery.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0350083","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T17:35:52Z","timestamp":1780076152000},"page":"e0350083","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Risk factors for post-induction hypotension in patients with end-stage renal disease undergoing general anesthesia"],"prefix":"10.1371","volume":"21","author":[{"given":"Supachai","family":"Trikisayaveach","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3863-8582","authenticated-orcid":true,"given":"Laortip","family":"Rattanapittayaporn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jatuporn","family":"Pakpirom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chutida","family":"Sungworawongpana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suttasinee","family":"Petsakul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"issue":"5","key":"pone.0350083.ref001","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1016\/j.bja.2023.08.026","article-title":"Intraoperative hypotension and postoperative outcomes: a meta-analysis of randomised trials","volume":"131","author":"F D\u2019Amico","year":"2023","journal-title":"Br J Anaesth"},{"issue":"2","key":"pone.0350083.ref002","doi-asserted-by":"crossref","first-page":"90","DOI":"10.4103\/ija.IJA_939_19","article-title":"Intraoperative hypotension: Pathophysiology, clinical relevance, and therapeutic approaches","volume":"64","author":"K Kouz","year":"2020","journal-title":"Indian J Anaesth"},{"issue":"1","key":"pone.0350083.ref003","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1213\/ANE.0000000000007074","article-title":"Intraoperative Hypotension in Patients Having Major Noncardiac Surgery Under General Anesthesia: A Systematic Review of Blood Pressure Optimization Strategies","volume":"141","author":"S Lee","year":"2025","journal-title":"Anesth Analg"},{"issue":"22","key":"pone.0350083.ref004","first-page":"7044","article-title":"A systematic review of risk factors for postinduction hypotension in surgical patients undergoing general anesthesia","volume":"25","author":"B Chen","year":"2021","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"pone.0350083.ref005","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1097\/EJA.0000000000001192","article-title":"Preanaesthesia ultrasonography of the subclavian\/infraclavicular axillary vein for predicting hypotension after inducing general anaesthesia","volume":"37","author":"MH Choi","year":"2020","journal-title":"Eur J Anaesthesiol"},{"issue":"1","key":"pone.0350083.ref006","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.aan.2024.07.006","article-title":"Mitigating Intraoperative Hypotension: A Review and Update on Recent Advances","volume":"42","author":"W Saasouh","year":"2024","journal-title":"Adv Anesth"},{"issue":"1","key":"pone.0350083.ref007","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1186\/s13741-024-00414-7","article-title":"Hypotension prediction index for prevention of intraoperative hypotension in patients undergoing general anesthesia: a randomized controlled trial","volume":"13","author":"C-J Lai","year":"2024","journal-title":"Perioper Med (Lond)"},{"issue":"4","key":"pone.0350083.ref008","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1016\/S0889-8537(05)70199-1","article-title":"Anesthetic considerations for the patient with renal failure","volume":"18","author":"RN Sladen","year":"2000","journal-title":"Anesthesiol Clin North Am"},{"key":"pone.0350083.ref009","article-title":"Intraoperative hypotension associated with postoperative acute kidney injury in hypertension patients undergoing non-cardiac surgery: a retrospective cohort study","volume":"12","author":"J Li","year":"2024","journal-title":"Burns Trauma"},{"key":"pone.0350083.ref010","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.amjsurg.2024.02.001","article-title":"Intraoperative hypotension and postoperative acute kidney injury: A systematic review","volume":"232","author":"Y Penev","year":"2024","journal-title":"Am J Surg"},{"issue":"3","key":"pone.0350083.ref011","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1213\/01.ANE.0000175214.38450.91","article-title":"Predictors of hypotension after induction of general anesthesia","volume":"101","author":"DL Reich","year":"2005","journal-title":"Anesth Analg"},{"issue":"6","key":"pone.0350083.ref012","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1093\/bja\/aew126","article-title":"The effect of propofol on haemodynamics: cardiac output, venous return, mean systemic filling pressure, and vascular resistances","volume":"116","author":"F de Wit","year":"2016","journal-title":"Br J Anaesth"}],"updated-by":[{"DOI":"10.1371\/journal.pone.0356297","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000}}],"container-title":["PLOS 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