Influence factors of intradialytic hypertension in maintenance hemodialysis patients

Objective To investigate the influence factors of intradialytic hypertension ( IDH ) in maintenance hemodialysis patients. Methods A total of fifty three patients with end-stage kidney disease , who underwent hemodialysis ( 6890times a year ) in the First Affiliated Hospital of Fujian Medical from January 1 , 2010to December 31 , 2010 , were enrolled. The correlation between IDH and the outcome measures , including urea clearance index ( Kt / v ), interdialytic weight gain ( IDWG ), ultrafiltration ( UF ) rate , intact parathyroid hormone ( iPTH ), erythropoietin , average hospitalization rate , incidence of complications of cardiovascular and cerebrovascular disease , in dialysis were investigated. According the occurrences of IDH , they were divided into group A ( ≥3times , n=19 ) and group B ( ≤2times , n=34 ) . Results Compared with those of group B , the dialysis frequency [( 2.1±0.3 ) vs ( 3.0± 0.7 ) times / week ], Kt / v [( 0.8±0.1 ) vs ( 1.3±0.1 )], hemoglobin ( HGB )[( 96.4±3.8 ) vs ( 102.1±2.1 ) g / L ] of group A were lower ( P0.05 ) . While blood pressure change after dialysis variations [ systolic blood pressure : ( 26.4±11.0 ) vs ( 8.2±6.8 ); diastolic blood pressure :( 10.2±4.8 ) vs ( 4.0±1.2 ) mm Hg ], IDWG [( 3.8±1.2 ) vs ( 2.1±0.9 ) kg ], UF rate [( 15.3±0.2 ) vs ( 9.1±0.4 ) mL /( h · kg )], iPTH [( 564.5±68.7 ) vs ( 365.9± 46.9 ) ng / L ], the treatment rate ( 100%vs 87% ) and mean doses [( 10 000±1546 ) vs ( 8856±1287 ) U / W ] of eryth- ropoietin ( EPO ), average hospitalization rate [( 0.7±0.2 ) vs ( 0.3±0.3 ) times / year ], relative cardiovascular and cerebrovascular complications incidence ( 64% vs 12% ) were all higher in group A ( P0.05 ) . In terms of single dialysis , the IDWG , ultrafiltration rate , average heart rate of intradialysis , pre-dialysis mean arterial blood pressure( PreMAP ) of the cases without IDH were lower than those with IDH ( P0.05 ) . Multivariate Losgistic regression analysis revealed that IDWG , dialysis frequency , average heart rate of intradialysis , PreMAP , ultrafiltration rate were influence factors of IDH. Conclusions IDH is correlated with IDWG , PreMAP , average heart rate of intradialysis , and dialysis adequacy.