Association of residual renal function with intradialysis hypotension in maintenance dialysis patients

Abstract

Objective To investigate the association of residual renal function with intradialysis dialysis hypotension among maintenance hemodialysis patients. Methods Fifty-six patients who had underwent maintenance hemodialysis from March 2014 to November 2015 were enrolled according to researching protocol in this study. Data of baseline and clinical parameter of every hemodialysis session were collected. The patients were divided into two groups by 24 h urine output:urine group (24 h urine output ≥ 100 ml, 22 patients)and no urine group (24 h urine output<100 ml, 34 patients). The clinical data were compared between two groups. Results In the 12 weeks’ treatment, 965 times hemodiafiltration were performed in 56 patients, and the rate of intradialysis hypotension was 24.04%(232/965). The rate of intradialysis hypotension in urine group was 19.28%(80/415), in no urine group was 27.64%(152/550), and there was significant difference (P = 0.000). The levels of interdialytic weight gain, ultrafiltration volume, ultrafiltration percentage , pre-dialysis systolic and diastolic blood pressure in urine group were significantly lower than those in no urine group (P 0.05). Pearson correlation analysis showed that residual glomerular filtration rate (rGFR) had negative correlation with interdialytic weight gain (r = - 0.257, P = 0.001). Kaplan-Meier analysis showed that with the increase of dialysis time, the rate of intradialysis hypotension increased. The comulative rate of intradialysis hypotension in no urine group was higher than that in urine group (log-rank = 14.67, P= 0.000). Conclusions Residual renal function is associated with intradialysis hypotension, and it is important for clinician to consider a residual renal function protection schedule for maintenance hemodialysis patients. Key words: Hemodiafiltration; Residual renal function; Intradialysis hypotension