Abstract: 【Abstract】Objective To analyze the risk factors and prevalence of different types of heart failure (HF) in maintenance hemodialysis (MHD) patients with HF. Methods Clinical, laboratory and echocardiographic data of 152 MHD patients with HF were retrospectively analyzed. The risk factors for HF were investigated
by comparison of HF with preserve ejection fraction (HFpEF), HF with mid-range of ejection fraction (HFmrEF) and HF with reduced ejection fraction (HFrEF) groups. Multivariate logistic regression and multivariate linear regression analyses were used for the analyses. Results A total of 152 MHD cases with HF were enrolled in this study; 110 of the 152 patients (72.4%) had HFpEF, 16 (10.5%) had HFmrEF, and 26 (17.1%) had HFrEF. Compared to HFpEF group, patients in HFrEF group had higher prevalence of grade Ⅳ HF (χ2=6.369, P=0.041) and lower levels of systolic pressure (SBP, t=3.144, P=0.002), uric acid (UA, t=2.131, P=0.033) and plasma albumin (ALB, t=2.933, P=0.003). Compared to HFpEF and HFmrEF groups, patients in HFrEF group had higher level of hemoglobin (HB) (t=3.211, P=0.001, compared to HFpEF group; t=0.789, P=0.005, compared to HFmrEF group). Compared to HFmrEF and HFrEF groups, patients in HFpEF group had lower levels of left atrium (LA; t=3.055, P=0.002, compare to HFmrEF group; t=2.151, P=0.031, compared to HFrEF group), and left ventricular end diastolic diameter (LVDd; t=5.461, P＜0.001, compared to HFmrEF group; t=4.307, P=0.000, compared to HFrEF group). Multivariate logistic regression displayed that SBP (OR 0.338, 95% CI 0.086～0.263, P=0.000), HB (OR 0.188, 95% CI -0.024～-0.033, P=0.010), and LVDd (OR 0.563, 95% CI -1.421～-0.743, P＜0.000) were the risk factors for left ventricular ejection fraction (LVEF). The risk factors for LVEF were also verified by multivariate linear regression (t=7.906, P=0.004 for SBP; t=-4.191, P=0.025 for HB; t=- 5.582, P=0.011 for LVDd). Conclusions HFpEF was relatively prevalent in MDH patients with HF. Increased SBP, decreased HB and LVDd were the risk factors for HFpEF in MHD patients with HF.

Key words: Maintain hemodialysis, Heart failure, Influential factor