Analysis of influencing factors of poor blood pressure control in maintenance hemodialysis patients and construction of Nomogram prediction model
TAN Lanjing
LIANG Tuzhen
WU Henghui
LIN Bixia
Abstract：Objective:To analyze the related factors of poor blood pressure control in maintenance hemodialysis(MHD)patients,and to construct a Nomogram prediction model and verify it.Methods:A total of 96 MHD patients admitted to the hospital from March 2020 to February 2023 were selected as the study objects.According to the blood pressure during dialysis,the patients were divided into observation group(poor blood pressure control,n=19)and control group(good blood pressure control,n=77).The clinical data of the two groups were statistically analyzed.Logistic regression model was used to analyze MHD patients independent risk factors for poor control of blood pressure.R software was used to construct a Nomogram model for predicting poor blood pressure control in MHD patients.The calibration curve was used to validate the prediction model.The decision curve analysis was used to evaluate the net clinical benefit of the prediction model.Results:The proportion of patients with standard dry weight,good nutritional status,Kt/V≥1.2,the proportion of patients with prescribed antihypertensive drugs and the proportion of patients with ≥3 antihypertensive drugs in the observation group were lower than those in the control group(all P＜0.05).Dry weight substandard,poor nutritional status,Kt/V＜1.2 and non-prescribed use of antihypertensive drugs were independent risk factors for poor blood pressure control in MHD patients(P＜0.05).The validation results showed that the C-index of the Nomogram prediction model was 0.812[95％CI(0.545,0.986)],which showed good consistency between the observed value and the predicted value.Decision curve analysis shows that this predictive model can provide additional net clinical benefits when the risk threshold was greater than 0.09.Conclusions:The Nomogram prediction model of MHD patients with poor blood pressure control has good predictive value,which helps medical staff to recognize the risk factors of poor blood pressure control in MHD patients and conduct targeted nursing intervention early,so as to improve the blood pressure control of MHD patients.
Keywords：maintenance hemodialysisblood pressureinfluencing factorNomogram prediction model
Publication Date：2024-12-31
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 4644-4648 )