Intradialytic BP variability is associated with cardiovascular mortality and hospitalization in HD patients.

Studies showed that pre-dialysis blood pressure variability (BPV) was an independent risk factor of cardiovascular disease (CVD) among hemodialysis (HD) patients, but which is limited on how intradialytic BPV affects prognosis. In this study, we designed a retrospective cohort study to examine the association between intradialytic BPV and CVD outcomes in HD patients. A total of 202 patients who underwent HD in our center was included, and all intradialytic blood pressure measurements of November 2017 were obtained from the database. Patients were divided into four groups according to variability independent of the mean (VIM) interquartile. The mean age was 62.1 ± 14.3 years, 60.9% were male, median VIM was 14.75 (12.60-18.59). Multiple-regression analyses showed patients age, dialysis vintage, serum albumin, and intradialytic weight gain (IDWG%) as significant predictors of VIM (all p were < 0.05). Kaplan-Meier survival curves showed that CVD mortality was greater in patients with higher VIM (p = 0.05), whereas all-cause mortality had no significant difference between the four groups overall (p = 0.149). Furthermore, multivariate regression analyses demonstrated that VIM (HR = 1.091, p < 0.004) and age (HR = 1.059, p = 0.003) were significant independent predictors for CVD death. Logistic-regression models revealed that higher VIM groups were more likely to have CVD related hospitalization (OR = 1.085, p = 0.030), whereas the association between VIM and all-cause hospitalization was not statistically significant (OR = 1.015, p = 0.669). This retrospective study suggested that higher intradialytic BPV was associated with increasing age, longer dialysis vintage, lower albumin, and greater ultrafiltration; intradialytic BPV could be an effective predictor for CVD mortality and hospitalization in the HD population. This article is protected by copyright. All rights reserved.