Impact of Long-Term Blood Pressure Variability on Survival Rate in Elderly Maintenance Hemodialysis Patients: A 46-Month Follow-Up Study of 245 Patients.

Abstract

BACKGROUND At present, there are few blood pressure variability (BPV)-related studies of elderly maintenance hemodialysis (MHD) patients. This study aimed to compare the effects of long-term BPV on the 46-month survival rate of MHD patients aged <75 years and ≥75 years between 2000 and 2014, with follow-up until 2018. MATERIAL AND METHODS According to systolic blood pressure variability (SBPV) and diastolic blood pressure variability (DBPV), patients were divided into 4 groups: a low SBPV group (n=121), a high SBPV group (n=122), a low DBPV group (n=114), and a high DBPV group (n=112). RESULTS We included 243 patients in the study. All the patients were followed up for 46 months, and 59 patients (28 males) died during follow-up. The survival rate of patients in the high SBPV group was significantly lower than that of the low SBPV group (log rank P=0.049). No significant differences were observed between the high DBPV group and low DBPV group (log rank P=0.167). There were no significant differences in survival rates between the high SBPV group and low SBPV group among patients aged <75 years (log rank P=0.656), and among patients ≥75 years, the survival rate of the high SBPV group was significantly lower than that of the low SBPV group (log rank P=0.041). CONCLUSIONS Increased long-term SBPV in MHD patients is associated with a decrease in long-term survival rate, and patients ≥75 years are more susceptible to it.