Abstract: 【Abstract】 Objective To evaluate the prevalence of hypertension in maintenance hemodialysis (MHD) patients, and to analyze the clinical and biochemical variables relating to hypertension. Methods We retrospectively analyzed the characteristics of hypertension and tried to find out the causes leading to unsatisfactory control of hypertension in 108 MHD patients in authors’ hospital. We observed their blood pressure change after individualized anti-hypertension therapy for 6 months. We also monitored their clinical and biochemical variables, blood pressure and body weight after each dialysis session for 2 weeks. Result The prevalence of hypertension was 85.2% in this cohort of patients, of which 52.2% were systolic hypertension, 2.1% were diastolic hypertension, and 22.8% were systolic and diastolic hypertension. Logistic regression analyses indicated that the independent risk factors for systolic hypertension before dialysis were intradialysis weight gain (β=1.932, P=0.012), percentage of body weight gain (β=9.85, P=0.030), serum iPTH (β=0.005, P=0.002), and inadequate dialysis (β= -3.448, P=0.008). After the individualized therapy for 6 months, blood pressure returned to satisfactory level in 57.4% patients; intradialysis weight gain (2.90±0.92kg vs. 3.43±1.15kg), percentage of body weight gain (4.17±1.59% vs. 4.75±1.90%), and the daily dose of anti-hypertension drugs (3.55±1.31 vs 3.00±1.26) decreased significantly (P<0.05). Conclusion The independent risk factors for hypertension before dialysis in MHD patients were higher intradialysis body weight gain, inadequate dialysis, and increased serum parathyroid hormone. Therefore, the essential measures for hypertension control in MHD patients are reduction of intradialysis body weight gain and prevention of volume overload.

Key words: Hypertension, Volume overload