Abstract: Objective Blood pressure variability (BPV) is a putative risk factor for cardiovascular disease and mortality in maintenance hemodialysis (MHD) patients. The purposes of this study are to determine whether pre-dialysis BPV correlates to all-cause mortality in this cohort of MHD patients. Methods A total of 50 MHD patients were enrolled in this study. During the period from March 1st, 2011 to May 1st, 2011, their systolic pressure (SBP) and diastolic pressure (DBP) were recorded before every dialysis session for 2 weeks, and the mean systolic pressure (SBP) and mean diastolic pressure (DBP) were calculated. BPV was expressed as coefficient of variability, and their survival status and the cause of death were recorded in the next 5 years. The patients were then divided into survival group and death group. Results Systolic blood pressure variability (SBPV) and diastolic blood pressure variability (DBPV) were 8.5±2.1% and 9.3±2.8%, respectively. Twelve of the 50 patients (24.0%) died in the 5 years of follow-up period. Analyses using one-way ANOVA showed that age (F=19.817, P＜0.001), BMI (F=8.012, P=0.007), IVS (F=7.655, P=0.008), LAD (F=4.379, P=0.042), SBPV (F=21.977, P＜0.001) and DBPV (F=22.433, P＜0.001) were significantly higher in death group than in survival group. Meanwhile, SBP (F=4.081, P=0.049), DBP (F=5.871, P=0.019) and serum creatinine (F=8.375, P=0.006) were lower in death group than in survival group. Patients with diabetes had higher mortality than those without diabetes (c2=5.852, P=0.016). Multivariate binary logistic regression to analyze the statistically significant variables using death and survival as the dependent variables found that age (OR=1.186, 95% CI 1.108～1.381, P=0.028), diabetes (OR=3.250, 95% CI 1.235～8.554, P=0.017), serum creatinine (OR=0.993, 95% CI -0.985～0.000, P=0.046), SBPV (OR=2.622, 95% CI 1.346～5.109, P=0.005) and DBPV (OR=2.147, 95% CI 1.059～4.352, P=0.034) were independently correlated with all-cause mortality. SBP and DBP were not included in the regression analyses. Conclusion Pre- dialytic SBPV and DBPV may be the independent risk factors for all-cause mortality in MHD patients.

Key words: Hemodialysis, Blood pressure variability,  , Pre-dialysis