BackgroundThe association between Interdialytic home blood pressure variability (BPV) and the prognosis of patients undergoing maintenance hemodialysis (MHD) largely unknown.HypothesisWe proposed the hypothesis that interdialytic home BPV exert effect on cardiac and all‐cause mortality among individuals undergoing MHD.MethodsA total of 158 patients receiving MHD at the hemodialysis unit of Wuhan Fourth Hospital between December 2019 and August 2020 were included in this prospective cohort study. Patients were divided into tertiles according to the systolic BPV (SBPV), and the primary endpoints were cardiac and all‐cause death. Kaplan–Meier analysis was used to assess the relationship between long‐term survival and interdialytic home SBPV. In addition, Cox proportional hazards regression models were used to identify risk factors contributing to poor prognosis.ResultsThe risk of cardiac death and all‐cause death was gradually increased in patients according to tertiles of SBPV (3.5% vs. 14.8% vs. 19.2%, p for trend = .021; and 11.5% vs. 27.8% vs. 44.2%, p for trend <.001). The Cox regression analysis revealed that compared to Tertile 1, the hazard ratios for all‐cause mortality in Tertile 2 and Tertile 3 were 3.13 (p = .026) and 3.24 (p = .021), respectively, after adjustment for a series of covariates.ConclusionsThe findings revealed a positive correlation between increased interdialytic home SBPV and elevated mortality risk in patients with MHD.

中文翻译：

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透析间家庭收缩压变异增加血液透析患者的全因死亡率

背景透析间家庭血压变异性 (BPV) 与接受维持性血液透析 (MHD) 患者的预后之间的关系在很大程度上尚不清楚。假设我们提出了这样的假设：透析间家庭血压变异性对接受 MHD 的个体的心脏死亡率和全因死亡率有影响。本前瞻性队列研究纳入2019年12月至2020年8月期间在武汉市第四医院血液透析室接受MHD的158例患者。根据收缩期 BPV (SBPV) 将患者分为三组，主要终点是心脏死亡和全因死亡。 Kaplan-Meier 分析用于评估长期生存率与透析间家庭 SBPV 之间的关系。此外，使用Cox比例风险回归模型来识别导致不良预后的危险因素。结果根据SBPV的三分位数，患者心源性死亡和全因死亡的风险逐渐增加（3.5% vs. 14.8% vs. 19.2%） ,p趋势 = .021； 11.5% vs. 27.8% vs. 44.2%，p对于趋势<.001）。 Cox回归分析显示，与Tertile 1相比，Tertile 2和Tertile 3的全因死亡率风险比为3.13（p= .026) 和 3.24 (p在调整一系列协变量后，分别为 0.021）。结论 研究结果显示，透析间家庭 SBPV 增加与 MHD 患者死亡风险增加之间呈正相关。