Abstract: Objective  To investigate the influencing factors for intradialytic hypotension (IDH) in maintenance hemodialysis (MHD) patients, then to construct a risk prediction model and to evaluate the prediction effect of this model.  Methods  A total of 222 MHD patients in the Blood Purification Center of The Affiliated Hospital of North Sichuan Medical College from September 2020 to August 2021 were enrolled in this study as the study subjects. They were randomly divided into modeling group and modeling validation group in the patient number ratio of 6:4. Patients in the modeling group were further divided into IDH group and non-IDH group based on the definition of IDH in the National Kidney Foundation Kidney Disease Prognostic Quality Guidelines. Univariate analysis was used to analyze the risk factors for IDH. Multivariate logistic regression analysis was performed to obtain the factors with P<0.05 for construction of the risk prediction model. Hosmer-Lemeshow test model was used to test the goodness of fit of the model. ROC curve was used to examine the predictive value of the model. The effectiveness of the constructed model was then evaluated in the modeling validation group.  Results  The incidence of IDH was 40.09% in the MDH patients. Predialysis systolic blood pressure (OR=0.959, 95% CI=0.932~0.988, P=0.005), hemoglobin (OR=0.962, 95% CI=0.929~0.996, P=0.030), magnesium (OR=79.558, 95% CI=2.644~2393.594, P=0.012), diabetes (OR=16.066, 95% CI=4.914~52.530, P<0.001), and hypertension (OR=5.221, 95% CI=1.661~16.409, P=0.005) were the influencing factors for IDH. Hosmer-Lemeshow test gave the result of P=0.718. When the optimal cut-off value was set at 0.436, the area under the ROC curve (AUC) was 0.922, the sensitivity was 0.83 and the specificity was 0.887. The Youden index was 0.717, and the correct rate of practical application was 83.15%.  Conclusion The model we constructed can better predict the risk of IDH in MDH patients and provides a reference for clinicians to evaluate IDH in MHD patients.

Key words: Hemodialysis, Intradialytic hypotension, Influencing factor, Risk prediction model