Abstract: Objectives  To explore the influencing factors for intradialytic hypotension (IDH) in diabetic patients with maintenance hemodialysis (MHD).  Methods  A total of 140 diabetic patients on MHD during January 2017 to December 2019 were recruited from three hemodialysis centers in Beijing. They were divided into two group: IDH group (IDH episodes in more than 30% of dialysis sessions), and non-IDH group (IDH episodes in less than 30% dialysis sessions). Their clinical and laboratory data were collected and the potential impact factors for IDH were evaluated.  Results  There were 101 cases in IDH group and 39 case in non-IDH group. Logistic regression analysis showed that ultrafiltration rate (OR=1.229, 95% CI 1.017~1.487, P=0.033) and pre-hemodialysis systolic blood pressure (OR=1.048, 95% CI 1.013~1.083, P=0.007) were the independent influencing factors for IDH. ROC for the prediction of IDH demonstrated that the threshold of pre-hemodialysis systolic blood pressure was 159mmHg (AUC=0.702, 95% CI 0.604~0.801, P<0.001) and the threshold of ultrafiltration rate was 9.5ml/h/kg (AUC=0.657, 95% CI 0.551~0.762, P=0.004).  Conclusions   Pre-hemodialysis systolic blood pressure and ultrafiltration rate were the risk factors for IDH in diabetic patients with MHD.

Key words: Diabetes, Hemodialysis, Intradialytic hypotension, Pre-hemodialysis systolic blood pressure, Ultrafiltration rate