Risk Factors Of Chronic Hypotension In Maintenance Hemodialysis Patients

Objectives:To understand the distribution of TCM syndromes of maintenance hemodialysis(MHD)patients and the occurrence of chronic hypotension in these patients,and to analysis the risk factors for MHD patients to enter the chronic hypotension state.Methods:We collected the baseline data(including gender,age,medical history,blood pressure,biochemical indexes,TCM syndrome,and so on)of 173 MHD patients who undergoing dialysis in Hubei Provincial Hospital of TCM from January 1,2016 to January 1,2018.To observe the morbidity of chronic hypotension and the distribution of the TCM syndrome of them.We Used Cox regression model to find the related factors for patients to enter chronic hypotension.Results:1.A total of 173 patients were included,including 90 males and 83 females.Until the end of the study,a total of 16 patients had entered the chronic hypotension,and 5 were caused by the transfer,4 of whom died,and 148 patients did not enter the terminal.2.Of all the people,68 patients were diagonosed with Qi deficiency of spleen and kidney,35 with Liver-Kindey Yin deficiency,22 with spleen and kidney Yang deficiency,40 with deficiency of both Qi and Yin,8 with deficiency of Yin and Yang.There were 37 patients combining with moisture syndrome,31 with damp-turbidity sign,25 with damp-heat syndrome,20 with blood stasis syndrome.3.Among the 16 patients,there were 2 cases of spleen-kidney qi deficiency,3 cases of liver-kidney Yin deficiency,6 cases of spleen and kidney Yang deficiency,4 cases of qi and Yin deficiency,and only 1 of Yin and Yang deficiency syndrome.There were 3 cases of moisture syndrome,4 cases of damp-turbidity,2 cases of damp-heat and 7 cases of blood stasis syndrome.The mean arterial pressure of whom diagnosed with spleen and kidney Yang deficiency syndrome is 54 mm Hg.4.Single factor analysis showed that dialysisage,diabetes,hemoglobin,blood albumin,parathyroid hormone,C-reactive protein,Kt/V and the deficiency syndrome of TCM may be risk factors for those patients to enter chronic hypotension.5.Multivariate Cox regression analysis showed that diabetes and longer period of hemodialysis were the risk factors.Conclusions:1.Of all the 173 patients,the spleen and kidney deficiency of Qi accounted for the most in the distribution of the deficiency syndrome and the moisture syndrome accounted for the most in the distribution of the accompanying symptoms.2.The incidence of chronic hypotension in the 173 hemodialysis patients is 9.25%.3.Among the 16 patients,spleen and kidney Yang deficiency accounted for the most in the distribution of the deficiency syndrome and blood stasis accounted for the most in the distribution of the accompanying symptoms.The mean arterial pressure of whom diagnosed with spleen and kidney Yang deficiency syndrome is lower than that of other syndromes.4.When the patients all diagonosed with diabetes,the risk of patients whose dialysis age are over 5 years to enter chronic hypotension was 4.71 times than that of patients with dialysis age less than 5 years.When patients?age of dialysis are the same,those diabetics were 2.61 times more likely to enter chronic hypotension than those without diabetes.