Study on the Influencing Factors of Blood Pressure Variability in Patients Undergoing Maintenance Hemodialysis

Objective: To investigate the influencing factors of blood pressure variability (BPV) in patients with maintenance hemodialysis (MHD), so as to improve the patients' prognosis. Methods: The clinical data of 107 MHD patients were retrospectively analyzed. According to intradialytic systolic pressure (SBP)-BPV, the patients were assigned into high SBP-BPV group (n=52) and low SBP-BPV group (n=55). According to intradialytic diastolic pressure (DBP)-BPV, they were divided into high DBP-BPV group (n=49) and low DBP-BPV group (n=58). The basic characteristics of patients in high and low SBP-BPV groups and DBP-BPV groups were compared, and the influencing factors of both SBP-BPV and DBP-BPV were also analyzed. Results: The differences were statistically significant between high and low SBP-BPV groups by comparison to the age, dry weight, body mass index (BMI), dialysis age, interdialysis weight gain (IDWG) rate, pre-dialysis SBP, albumin (ALB), hemoglobin (Hb), total cholesterol (TC) and calcium-phosphorus product (P<0.05 or P<0.01). The differences were also statistically significant between high and low DBP-BPV groups by comparison to the age, dry weight, BMI, IDWG rate, pre-dialysis SBP and DBP, Hb and calcium-phosphorus product (P<0.05 or P<0.01). Multiple linear regression analysis revealed that SBP-BPV was positively correlated with the age, IDWG rate and pre-dialysis SBP (P=0.002, P=0.001, P=0.006), while negatively with Hb (P=0.021). They were all regarded as independent influencing factors of SBP-BPV. Both IDWG rate and pre-dialysis DBP were positively correlated with DBP-BPV (P=0.019, P=0.004), and could be considered as independent influencing factors of DBP-BPV. Conclusion: Advanced age, increased IDWG%, pre-dialysis high SBP and decreased Hb are independent risk factors of SBP-BPV, and both increased IDWG rate and pre-dialysis high DBP are independent risk factors of DBP-BPV in intradialytic MHD patients. Pre-dialysis patients should positively control the weight gain and blood pressure, and ameliorate the nutritional status to stabilize intradialytic blood pressure, consequently improving the prognosis.