Analysis of current situation and influencing factors of hypertension in maintenance hemodialysis for patients with diabetic kidney disease
10.3760/cma.j.cn115455-20250121-00080
- VernacularTitle:糖尿病肾病患者血液透析并发高血压的现况及影响因素分析
- Author:
Yunyun CHEN
1
;
Chen QIAN
;
Lei WANG
;
Kanghua YANG
Author Information
1. 南京市高淳人民医院血液透析室，南京 211300
- Publication Type:Journal Article
- Keywords:
Diabetic kidney disease;
Hemodiafiltration;
Hypertension;
Influence factor
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(9):837-842
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To understand the current situation of hypertension in maintenance hemodialysis (MHD) for patients with diabetic kidney disease (DKD), and analyze the influencing factors of hypertension.Methods:A retrospective analysis was conducted on the data of 398 DKD patients who underwent MHD in Nanjing Gaochun People's Hospital and Nanjing Gaochun Hospital of Traditional Chinese Medicine from September 2022 to October 2024. The patients were assigned into hypertension group and control group based on presence or absence of hypertension. General information, dialysis parameters, and pre-dialysis laboratory indicators were collected and compared between two groups. Logistic regression model was performed to screen the influencing factors of hypertension in hemodialysis patients.Results:Among 398 DKD patients undergoing dialysis, 59 cases developed hypertension, with an incidence rate of 14.82%. The proportion of dialysis time<5 years, pre-dialysis systolic blood pressure (SBP), proportion of dialysate Ca 2+ concentration of 1.75 mmol/L, erythropoietin (EPO) usage, pre-dialysis Hcy and pre-dialysis blood phosphorus in hypertension group were higher than those in control group: 72.88% (43/59) vs. 54.28% (184/339), (129.57 ± 8.23) mmHg (1 mmHg = 0.133 kPa) vs. (133.79 ± 9.85) mmHg, 66.10% (39/59) vs. 43.36% (147/339), (4 062.71 ± 597.24) U/week vs. (2 748.36 ± 551.85) U/week, (20.09 ± 3.47) μmol/L vs. (16.81 ± 2.85) μmol/L, (2.45 ± 0.49) mmol/L vs. (2.27 ± 0.41) mmol/L ( P<0.05). Logistic regression analysis revealed that dialysis time<5 years ( OR = 2.479, 95% CI 1.281 to 4.799), dialysate Ca 2+ concentration of 1.75 mmol/L ( OR = 3.112, 95% CI 1.749 to 5.537), high EPO usage ( OR = 3.078, 95% CI 1.716 to 5.520), high pre-dialysis Hcy ( OR = 2.809, 95% CI 1.497 to 5.270), and high pre-dialysis blood phosphorus ( OR = 2.651, 95% CI 1.424 to 4.935) were risk factors for hypertension during dialysis in DKD patients ( P<0.05). Conclusions:DKD patients have a higher risk of developing hypertension during dialysis, especially those with dialysis time<5 years, dialysate Ca 2+ concentration of 1.75 mmol/L, high EPO usage, high pre-dialysis Hcy and blood phosphorus. Therefore, corresponding preventive measures should be implemented based on above factors in clinical practice to reduce the risk of hypertension.
