The Risk Factors of Hypotension in Patients with End-Stage Chronic Glomerulonephritis During Maintenance Hemodialysis.

Abstract

Objective: To investigate the risk factors of hypotension during maintenance hemodialysis in patients with end-stage chronic glomerulonephritis.

Methods: A total of 129 patients with end-stage chronic glomerulonephritis on maintenance hemodialysis admitted to our hospital from March 2022 to May 2024 were retrospectively analyzed, and the relevant clinical data of the patients were recorded. Univariate and multivariate logistic regression analysis were performed on various factors that may affect the occurrence of hypotension in patients, and the nomogram model was constructed. The receiver operating characteristic (ROC) curve was used to analyze the predictive risk of hypotension in patients with end-stage chronic glomerulonephritis on maintenance hemodialysis.

Results: A total of 9186 times of dialysis were completed in 129 patients, and 597 times of intradialysis hypotension (IDH) occurred in 46 patients, with an incidence of 6.50%. The patients were divided into IDH group and No-IDH group according to whether they had intradialytic hypotension (IDH). Univariate and multivariate logistic regression analysis showed that ultrafiltration rate, weight growth rate, vascular access type and plasma albumin were independent risk factors for hypotension in patients. A nomogram model was constructed based on the above factors. The area under the curve (AUC) of the nomogram model for predicting intradialytic hypotension (IDH) was 0.862.

Conclusion: Ultrafiltration rate >10 mL/min, weight growth rate >3%, long-term catheter vascular access and low plasma albumin level are independent risk factors for hypotension in patients with end-stage chronic glomerulonephritis undergoing maintenance hemodialysis. The nomogram model based on these factors has a high application value in identifying patients at high risk of hypotension.