Home blood pressure variability and its influencing factors in maintenance hemodialysis patients / 医学研究生学报

ABSTRACT

Objective Blood pressure variability (BPV) is an independent risk factor for the death of patients with maintenance hemodialysis (MHD).There is no study on the influencing factors of BPV at home in HD patients in China.The article aimed to investigate MHD patients'BPV at home and related influencing factors in order to provide theoretical basis for reducing home BPV (HBPV) clinically. Methods We chose 103 patients who were treated with MHD in the Renal Medicine Room of Nephrology Department in three upper first -class hospitals including Jiangsu Provincial People 's Hospital, the First Affiliated Hospital of Suzhou University and the Affiliated Hospi -tal of Jiangsu University from March 2017 to October 2017.We col-lected their 7 days'blood pressure monitoring at home and blood pressure before dialysis, average value and standard deviation in sys -tolic blood pressure monitoring at home, and took the coefficient of variation of systolic blood pressure as the expression of HBPV .The patients were divided into high BPV group (BPV≥5.8％) and low BPV group (BPV<5.8％) according to the average BPV.At the same time, we recorded indexes such as sex , age, dialysis age, primary disease, BMI, inter-dialytic weight gain (IDWG), left ven-tricular mass index(LVMI) and analyzed relative influencing factors by multiple linear regression . Results The age, IDWG and LV-MI were positive independent influencing factors of HBPV (R 2 =0.467,F=10.945,P<0.001).According to standardized regression co-efficient, the contribution of each variable to HBPV was as follows PIBWG >Age>LVMI. Conclusion In clinical nursing, we should actively control the IDWG of patients , encourage patients to monitor their blood pressure at home , and increase their awareness of the importance of home BPV.Meanwhile, HBPV is an important index for predicting left ventricular hypertrophy and can be used as an objective tool to improve patients 'self-management ability.