Risk factors for cardiovascular and cerebrovascular events in patients with uremia and hypertension during maintenance hemodialysis.

OBJECTIVES: This study aimed to investigate risk factors for major adverse cardiovascular and cerebrovascular events (MACCEs) in patients with uremia and hypertension during maintenance hemodialysis (MHD).

METHODS: Clinical data of patients with uremia and refractory hypertension admitted to Changzhou Fourth People's Hospital (Changzhou Tumor Hospital) from February 2018 to February 2022 were retrospectively collected and analyzed. All patients were treated with MHD and categorized into an MACCE group and a non-MACCE group according to whether MACCEs occurred during the treatment cycle. Univariate analysis and multivariate logistic regression analysis were applied to identify the risk factors for MACCEs in the patients during the treatment period.

RESULTS: (1) A total of 156 patients were included in this study, among whom 75 patients were in the MACCE group and 81 in the non-MACCE group, with an MACCE incidence of 48.08%. (2) Diabetes, body mass growth rate, triglyceride (TG), N-terminal pro-brain natriuretic peptide (NT-proBNP), as well as the standard deviation (SD) and coefficient of variability (CV) for both systolic (SBP) and diastolic blood pressure (DBP) showed significant differences between the two groups, with P<0.05. (3) Diabetes, body mass growth rate ≥5.54%, TG≥1.40 mmol/L, NT-proBNP≥5.82 ng/L, SBP-SD≥13.52, SBP-CV≥8.63, DBP-SD≥8.14, and DBP-CV≥8.82 were found to be risk factors for MACCEs in the patients.

CONCLUSIONS: The incidence of MACCEs in patients with uremia and hypertension during MHD was associated with diabetes, body mass growth rate, TG, NT-proBNP, SBP-SD, SBP-CV, DBP-SD, and DBP-CV.Early screening for high-risk patients and positive intervention measures should be given to reduce the risk of MACCEs to enhance the safety of dialysis procedures.