Intradialytic systolic blood pressure (SBP) changes are related to the volume status; however, whether SBP change impacts on adverse outcomes depends on the volume status remains uncertain. We retrospectively investigated the relationship among intradialytic changes in SBP, cardiovascular outcomes, and volume status in maintenance hemodialysis patients. We determined SBP changes (ΔSBP) as postdialysis SBP minus predialysis SBP and volume status as the ratio of extracellular water to total body water (ECW/TBW) using bioelectrical impedance analysis. There were 82 (60.3%) with ΔSBP −20 to 10 mm Hg, 21 (15.4%) with ΔSBP ≤ −20 mm Hg, and 33 (24.3%) with ΔSBP ≥ 10 mm Hg, and they were followed up for a median of 34 months. Cardiovascular events more frequently occurred in the patients with ΔSBP ≤ −20 mm Hg and ≥ 10 mm Hg (hazard ratio: 2.3 and 3.0; P = .062 and .006); these associations persisted even after adjusting for postdialysis ECW/TBW (P = .056 and .028). Moreover, ΔSBP ≥ 10 mm Hg was associated with increased cardiovascular mortalities independent of postdialysis ECW/TBW (P = .043). There was an independent association of volume status between considerable SBP decrease or increase during hemodialysis and adverse cardiovascular outcomes. Besides appropriate volume control, other factors related to BP changes during hemodialysis must be investigated.

透析内收缩压（SBP）的变化与容量状态有关；但是，SBP变化是否会对不良结局产生影响取决于音量状态仍不确定。我们回顾性研究了维持性血液透析患者的SBP透析内变化，心血管预后和容量状态之间的关系。使用生物电阻抗分析，我们将SBP变化（ΔSBP）定义为透析后SBP减去透析前SBP，并将体积状态确定为细胞外水与全身水的比例（ECW / TBW）。ΔSBP-20至10 mm Hg的有82（60.3％），ΔSBP≤-20 mm Hg的有21（15.4％）和ΔSBP≥10 mm Hg的33（24.3％），并进行了中位随访为期34个月。ΔSBP≤-20 mm Hg和≥10 mm Hg的患者中，心血管事件更为频繁（危险比：2.3和3.0；P  = .062和.006）；即使对透析后ECW / TBW进行了调整，这些关联仍然存在（P  = .056和.028）。此外，ΔSBP≥10 mm Hg与心血管死亡率增加相关，而与透析后ECW / TBW无关（P  = .043）。血液透析期间SBP显着降低或升高与不良心血管结果之间存在体积状态的独立关联。除了适当的音量控制外，还必须研究与血液透析过程中血压变化有关的其他因素。