Effect Of On-line Blood Volume Monitoring On Patients With Refractory Hypertension During Maintenance Hemodialysis

Objective:To understand the effect of online blood volume monitoring(BVM)system on adjusting dry weight(DW)and improving blood pressure in patients with maintenance hemodialysis(HD)refractory hypertension(RFH),and to provide more optimized and accurate clinical treatment guidance for HD patients with RFH.Methods:RFH patients in the hemodialysis center of the Affiliated Hospital of Qinghai University from November 2019 to October 2020 were selected as the research subjects.A self-controlled study was conducted before and after the study.In the early stage,ordinary dialysis treatment was given for 4 weeks,and in the later stage,BVM adjusted dialysis treatment was given on the basis of ordinary dialysis treatment for 4 weeks.With the help of the volume change curve provided by the online blood volume monitoring device,dialysis was adjusted by observing the curve change in time.blood pressure,body weight,dry body weight,△BV,KT /V and other indexes were recorded before and after each dialysis,and the differences of relevant indexes between the two modes of dialysis treatment were analyzed.Results:(1)Compared with the normal dialysis mode,the patients’ post-dialysis blood pressure,body weight and dry body weight decreased after 4 weeks of BVM dialysis treatment,with statistical significance(P < 0.001).(2)Compared with the normal dialysis mode,the dialysis △BV of patients after 4 weeks of BVM dialysis treatment was higher than before,and the difference was statistically significant(P <0.001).(3)Compared with the normal dialysis mode,the post-dialysis KT/V value of patients after 4 weeks of BVM dialysis treatment was higher than before,and the difference was statistically significant(P < 0.001).(5)The difference of ultrafiltration volume adjusted by BVM was positively correlated with the mean arterial pressure difference(r=0.832).Conclusions:1.Adjustment of BVM Dialysis Through online blood volume monitoring,patients’ dry weight can be adjusted in time,and blood pressure level can be improved in patients with HD refractory hypertension.2.Adjusting dialysis with BVM can improve the post-dialysis KT/V value of HD patients.3.Adjustment of dialysis by BVM can not only reduce patients’ blood pressure,but also reduce the dose of oral antihypertensive drugs in patients with RFH.