Abstract: Objective To analyze the risk factors for the occurrence of intra-dialytic hypotension (IDH) in the elderly patients undergoing maintenance hemodialysis (MHD). Methods The clinical data of the elderly MHD patients in Blood Purification Center of Zhongda Hospital Southeast University from June 2022 to June 2023 were retrospectively collected and analyzed, including general data, incidence of dialysis-related hypotension and laboratory indicators. Logistic regression was used to analyze hypotension-related risk factors in hemodialysis, and ROC curve was drawn to explore the predictive value of hypotension-related factors. Results A total of 128 elderly patients were enrolled, of which 52 elderly patients presented with a total of 682 times of IDH, with an incidence rate of 7.78%. According to the occurence of IDH, all the patients were divided into IDH group and non-IDH group, and Logistic regression analysis showed that long-term catheter (intra-arteriovenous fistula as reference, OR=7.94, 95%CI: 2.76-22.87, P <0.001), ultrafiltration rate＞8.8 mL/min (≤8.8 mL/min as reference, OR=5.40, 95%CI: 1.55-18.75, P=0.008) were independently associated with IDH. ROC curve analysis showed that the area under the curve (AUC) of the ultrafiltration rate predicting IDH was 0.712, Youden index was 0.357, the optimal cut-off value was 9.0 mL/min, the sensitivity was 67.3% and the specificity was 68.4%. Conclusions Long-term catheter access and ultrafiltration rate > 8.8 mL/min are risk factors for IDH in the elderly MHD patients. Ultrafiltration rate has certain predictive value for IDH in elderly MHD patients.

Key words: hemodialysis, hypotension, aged, risk factors