Objective To explore the relationships between dialysis adequacy and cardiovascular struc-ture and function in patients with maintenance hemodialysis(MHD).Methods Clinical data with respect to blood biochemical examinations,vascular calcification and 12 consecutive dialysis treatments were retrospec-tively collected for patients receiving hemodialysis more than three months.Adequate dialysis was defined as the urea reduction rate(URR)≥65％and single-pool urea clearance(spKt/V)1.2.Blood pressure variability(BPV)metrics including the difference in maximum and minimum BPs(Δ BP)and average real variation(ARV)were calculated,and multivariate regression analyses were conducted.Results A total of 90 Chinese MHD outpatients were included,with the mean age of 59.8±17.4 years and the median dialysis vintage of 28.3(12.3～46.8)months.Patients with inadequate dialysis(45 patients)had higher intradialysis systolic ΔBP(27.9±6.6 vs.25.1±6.5 mmHg,t=-2.035,P=0.045)and systolic BP-ARV[SBP-ARV(13.4±3.4)vs.(11.9±3.2)mmHg,t=-2.228,P=0.028]and greater coronary artery calcification score[CACs,461.0(96.0～1741.0)vs.99.5(1.0～1329.0),t=-2.045,P=0.041]than those with adequate dialysis(45 patients).Age(β=0.305,P=0.003),coronary heart disease(β=-0.255,P=0.014)and spKt/V(β=-0.290,P=0.006)were significantly corre-lated with intradialysis SBP-ARV;diabetes mellitus(OR=6.048,95％CI:1.168～31.330,P=0.032),low se-rum albumin levels(OR=0.817,95％CI:0.681～0.982,P=0.031)and spKt/V(OR=0.886,95％CI:0.786～0.998,P=0.047)were found to be independent risk factors for CACs≥ 400.Conclusions Inadequate dialysis was strongly associated with elevated intradialysis BPV and increased risk of severe coronary artery calcifica-tion in MHD patients.
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