Patterns of dialysis-related complications and their association with baseline characteristics in outpatient hemodialysis: a retrospective analysis of nursing documentation

To describe complication patterns documented in routine nursing records and explore their association with baseline demographic and diagnostic characteristics among outpatients with end-stage kidney disease (ESKD) on maintenance hemodialysis. The goal is to inform the development of nurse-led, documentation-informed observation protocols rather than to establish definitive predictive markers. A single-center, retrospective observational study was conducted using electronic nursing records from January 1, 2024, to April 30, 2025. Two reviewers independently extracted data. The analysis focused on patient-level occurrence (ever vs. never) of intradialytic hypotension (IDH) as the primary outcome. Session-level event counts are reported solely to contextualize nursing workload and do not represent incidence rates. Univariate screening ( P < 0.1) preceded multivariable binary logistic regression. At the patient level, increasing age showed a marginal inverse association with IDH occurrence. Diabetic nephropathy was also associated with lower recorded odds of IDH compared to the uremia reference group. Associations for other complications did not reach conventional significance and are interpreted as exploratory. Baseline characteristics demonstrate context-dependent associations with complication patterns captured in routine outpatient hemodialysis nursing documentation. Given the absence of dialysis prescription variables and the inherent limitations of retrospective chart abstraction, these observations are hypothesis-generating. Future prospective studies integrating real-time hemodynamic monitoring and structured nursing assessments are needed to validate these patterns.