Analysis of the correlation between blood pressure fluctuation and hemodialysis-related complications in patients with maintenance hemodialysis / 上海交通大学学报（医学版）

ABSTRACT

Objective: To explore the correlation between blood pressure fluctuation and chronic kidney disease-mineral and bone disorder (CKD-MBD) in patients with maintenance hemodialysis (MHD). Methods ¡¤ From Jan. 2009 to Apr. 2015, 433 MHD patients in Hemodialysis Center of Renji Hospital, Shanghai Jiao Tong University School of Medicine were included, and their clinical data, treatment parameters during dialysis, lab examination indexes and drug applications were collected. According to the difference value of systolic blood pressure (SBP) during dialysis period, all the patients were divided into high fluctuation group of blood pressure (|△ SBP| ≥ 10 mmHg, n=234) and low fluctua-tion group of blood pressure (|△ SBP|<10 mmHg, n=199). The blood pressure fluctuation and its relationship with dialysis adequacy, bone metabolism indicator and nutrition indicator were analyzed between the two groups. Results ¡¤ Compared with the low fluctuation group of blood pressure, the patients in the high fluctuation group of blood pressure took higher proportion of β receptor blockers and Vit D, higher level of serum P and intact parathyroid hormone (iPTH), higher dialysis age, and lower Kt/V, ultrafiltration volume, body mass index (BMI) and serum albumin (ALB) level (all P<0.05). The blood pressure fluctuation between the patients with different serum P and iPTH levels was statistically significant (all P<0.05). There was no statistically significant difference in blood pressure fluctuation between the patients with different serum Ca levels. Multivariate Logistic regression analysis showed that dialysis age, serum P and iPTH levels were independent risk factors for blood pressure fluctuation of MHD patients, while Kt/V and ALB were protective factors. Con-clusion ¡¤ Blood pressure fluctuation in MHD patients during dialysis period is significantly correlated with CKD-MBD, nutritional status, dialy-sis age and dialysis adequacy.