Risk Factors For DCD Kidney Recipients Hypertensive Crisis During The General Anesthesia Recovery Period

Objective:The effects of recipient gender,age,dialysis time,primary hypertension(non-nephrogenic),double kidney transplantation and donor hypertension in kidney transplant patients using donation after cardiac death(DCD)on hypertensive crisis during anesthesia recovery were retrospectively analyzed,and to explore the related factors that contribute to the occurrence of the hypertensive crisis,in order to achieve the timely and effective preventive intervention,reduce the occurrence of adverse reactions,and to ensure patients and grafts safety.Methods:Analyzing retrospectively emergency renal allograft operations performed in the First hospital of Jilin University from September 2019 to September 2021.According to exclusion and inclusion criteria,98 kidney transplant patients during the period were included in this study.Consult the surgical anesthesia record sheet and medical record system of the hospital of Jilin University,then to set up some case report forms,and to record the general information of patients(gender,age,dialysis time,primary hypertension,double kidney transplantation,donor renal hypertension and soon).According to the blood pressure during anesthesia recovery period,the patients were divided into hypertensive crisis group and stable blood pressure group,and to analyze and compare the clinical data of the two groups.Then by using Statistical software to analyze the influence of the above factors on the occurrence of hypertensive crisis during anesthesia recovery period.Results:Hypertensive crisis group compared with stable blood pressure group,the former had an older average age,a higher BMI,a larger proportion of receptors with essential hypertension,a larger proportion of hypertensive cerebral hemorrhage supplying kidney and a higher systolic blood pressure at T1(After entering the operating room clam period)and T2(anesthesia recovery period)(P<0.05).When confounding factors were eliminated,Logistic regression analysis showed that the age(OR 1.073,95%CI 1.018-1.132)and presence of essential hypertension(OR 0.286,95%CI 0.089-0.919)are contributing factors.ROC curve analysis was performed for the two independent influencing factors,it suggests that age and the presence of essential hypertension are significant in predicting the occurrence of hypertensive crisis during recovery from general anesthesia.When the age was over 44.5 years and the T1 blood pressure was over 146.5 mm Hg,the renal transplant patients were more likely to develop a hypertensive crisis during the recovery period of general anesthesia.Conclusions:The age and presence of essential hypertension are independent influencing factors of hypertensive crisis in renal transplantation patients during recovery period under general anesthesia,and the older the age and the presence of essential hypertension are the more likely to develop an awakening hypertensive crisis.In addition,compared with others factors,the incidence increases significantly in older patients for the probability of the occurrence of hypertensive crisis during anesthesia recovery period.