终末期肾病维持性血液透析患者透析中低血压发生的危险因素分析

Risk Factors for Intradialytic Hypotension in Maintenance Hemodialysis Patients with End-Stage Renal Disease

目的探讨终末期肾病维持性血液透析(MHD)患者透析中低血压(IDH)发生的危险因素.方法选取2022年2月—2023年5月该院收治的197例终末期肾病MHD患者为研究对象,统计IDH发生情况,并进行单因素分析与多因素Logistic回归分析以明确IDH发生的危险因素.结果197例终末期肾病MHD患者中有85例发生IDH,发生率为43.15%;IDH组超滤量≥5%、透析间增重率(IDWGR)≥5%、低白蛋白血症、透析液温度≥36℃患者占比高于非IDH组,组间差异有统计学意义(P﹤0.05);多因素Logistic回归分析结果显示,超滤量≥5%(OR=2.514)、IDWGR≥5%(OR=4.053)、低白蛋白血症(OR=4.521)、透析液温度≥36℃(OR=2.879)是影响终末期肾病MHD患者发生IDH的独立危险因素(P﹤0.05).结论终末期肾病MHD患者具有较高的IDH发生风险,其发生与超滤量≥5%、IDWGR≥5%、低白蛋白血症、透析液温度≥36℃等关系密切.

Objective To explore the risk factors for intradialytic hypotension(IDH)of maintenance hemodialysis(MHD)in patients with end-stage renal disease(ESRD).Methods 197 maintenance hemodialysis patients with end-stage renal disease admitted to the hospital from February 2022 to May 2023 were selected as the study subjects,statistics on the occurrence of IDH,and conduct univariate analysis and multivariate logistic regression analysis to identify the risk factors for IDH occurrence.Results Among 197 maintenance hemodialysis patients with end-stage renal disease,85 cases developed IDH,with an incidence rate of 43.15%.The proportion of patients with ultrafiltration volume≥5%,inter dialysis weight gain rate(IDWGR)≥5%,hypoalbuminemia,and dialysate temperature≥36℃in the IDH group was higher than that in the non IDH group,the difference between groups is statistically significant(P﹤0.05).The results of multivariate Logistic regression analysis showed that ultrafiltration volume≥5%(OR=2.514),IDWGR≥5%(OR=4.053),hypoalbuminemia(OR=4.521),and dialysate temperature≥36℃(OR=2.879)were independent risk factors for IDH in maintenance hemodialysis patients with end-stage renal disease(P﹤0.05).Conclusion Maintenance hemodialysis patients with end-stage renal disease have higher risk of developing IDH,which is closely related to ultrafiltration volume≥5%,IDWGR≥5%,hypoalbuminemia,and dialysate temperature≥36℃.