Analysis of the influencing factors for intradialytic hypotension in diabetic maintenance hemodialysis patients

doi:10.3969/j.issn.1006-7795.2025.05.015

Abstract

Abstract: Objective To study the influencing factors of intradialytic hypotension (IDH) in diabetic maintenance hemodialysis (MHD) patients, and to provide references for clinical prevention of IDH quality control. Methods A total of 200 diabetic patients from four hemodialysis centers in Beijing from March 2022 to September 2022 were collected as the research objects. According to the definition of IDH ［systolic blood pressure during hemodialysis≤90 mmHg (1 mmHg=0.133 kPa) or systolic blood pressure reduction during dialysis≥30 mmHg］, the patients were divided into IDH group ( frequency of hypotension events during dialysis ≥30 % during 7 months of follow-up) and non-IDH group. Univariate analysis and multivariate Logistic regression were used to analyze the influencing factors of IDH. receive operating characteristic curve(ROC) curve analysis was used to evaluate the predictive value of each influencing factor for IDH. Results Univariate analysis showed that compared with non-IDH group, IDH group had higher systolic blood pressure, higher blood glucose and lower serum albumin before dialysis (P<0.05). There were more patients with orthostatic hypotension in the IDH group than in the non-IDH group (P <0.05). Multivariate Logistic regression analysis showed that pre-dialysis systolic blood pressure, orthostatic hypotension and serum albumin were the influencing factors of IDH (P<0.05). ROC curve was used to evaluate the diagnostic accuracy of pre-hemodialysis systolic blood pressure for IDH. The area under the ROC curve was 0.787 (95% CI: 0.720-0.854, P<0.001), the threshold of IDH predicted by the Jorden index was 153 mmHg, the sensitivity was 75.5%, and the specificity was 75.4%. Conclusion Pre-hemodialysis systolic blood pressure, blood albumin and postural hypotension are independent factors of IDH in diabetic patients. In order to predict the occurrence of IDH, the pre-hemodialysis systolic blood pressure threshold was 153 mmHg.

Key words: diabetes mellitus, hemodialysis, intradialytic hypotension, pre-hemodialysis systolic blood pressure, postural hypotension, blood albumin, blood glucose

CLC Number:

R544.2

Yao Weihua, Zhang Liling, Diao Zongli, Song Dongqi, Gao Qian, Liu Wenhu. Analysis of the influencing factors for intradialytic hypotension in diabetic maintenance hemodialysis patients[J]. Journal of Capital Medical University, 2025, 46(5): 860-865.

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