Abstract: Objective To evaluate the factors relating to intradialytic abnormal blood pressure through observation of the incidence of hypotension and hypertension during hemodialysis sessions in patients with diabetic nephropathy. Methods Patients with diabetic nephropathy treated with maintenance hemodialysis were recruited in this study. The effects of gender, age, dialysis age, blood flow, dialyzer and ultrafiltration rate on blood pressure were observed. Results Dialysis age was the main factor relating to intradialytic abnormal blood pressure in patients with diabetic nephropathy. The patients were divided into four groups based on dialysis age, group A (≤1 year), group B (1 to 3 years), group C (3 to 5 years) and group D (≥5 years). The incidence of intradialytic hypotension was 13.8%, 22.5%, 26.7% and 37.2% in group A, B, C and D, respectively, significant different between the four groups (χ2=23.129, P＜0.001 for group A vs. group B;χ2=22.889, P＜0.001 for group B vs. group D; χ2=9.072, P =0.003 for group C vs. group D). The incidence of intradialytic hypertension was 22.3%, 14.2%, 12.2% and 8.1% in group A, B, C and D, respectively, significant different between group A and other groups (χ2=20.399, P＜0.001 for group A vs. group B; χ2=22.774, P＜0.001 for group Avs. group C; χ2=24.811, P＜0.001 for group A vs. group D). Ultrafiltration rate was related to intradialytic hypotension (P=0.006), but not related to intradialytic hypertension (P=0.585). While gender, age, dialyser flux and blood flow were unrelated to intradialytic hypotension (P=0.568, 0.059, 0.572, and 0.447, respectively) and hypertension (P=0.346, 0.337, 0.121, and 0.479, respectively). Conclusion With the increase of dialysis age, the incidence of intradialytic hypotension significantly increased but the incidence of hypertension significantly reduced. Ultrafiltration rate was related to intradialytic hypotension. To raise the tolerance to he-modialysis, preventive measures should be conducted to the dialysis age-related intradialytic abnormal blood pressure in patients with diabetic nephropathy under hemodialysis.

Key words: Diabetic nephropathy, Hemodialysis, Dialysis expectancy, Hypotension, Hypertension