Association Between Brain Natriuretic Peptide and Intradialytic Hypotension in Hemodialysis Patients: A Retrospective Study

Background: Intradialytic hypotension (IDH) is a common complication of hemodialysis (HD) and is associated with an increased risk of poor prognosis. This study investigated the factors associated with IDH in HD patients and explored the value of brain natriuretic peptide (BNP) in predicting IDH. Methods: Participants were divided into two groups according to the occurrence of IDH. Differences in clinical data between the IDH and no-IDH groups were analyzed, and the influencing factors of IDH were analyzed using logistic regression. A receiver operating characteristic (ROC) curve was applied to identify the optimal critical value of BNP for the occurrence of IDH in HD patients. Results: A total of 123 HD patients were included, in which the percentage of IDH was 30.9%. In patients with IDH, the levels of BNP (224.4 vs. 464.7 pg/mL, p = 0.001), pre-HD systolic blood pressure (SBP) (153.0 vs. 162.0 mmHg, p = 0.002), pre-HD diastolic blood pressure (DBP) (75.7 vs. 84.1 mmHg, p = 0.001), post-HD SBP (134.2 vs. 154.2 mmHg, p < 0.001) and DBP (72.8 vs. 84.0 mmHg, p < 0.001) were significantly lower than those in the non-IDH group, and the level of ejection fraction (66.5 vs. 64.1%, p = 0.039) was significantly higher. Univariate analysis showed that BNP [odds ratio (OR) = 0.999, p = 0.015], pre-HD SBP (OR = 0.960, p = 0.001), and DBP (OR = 0.944, p = 0.001) were associated with IDH. Multivariate analysis revealed that lower BNP levels (OR = 0.999, p = 0.030), lower pre-HD DBP levels (OR = 0.928, p = 0.009), and higher body mass index (BMI) (OR = 1.133, p = 0.032) were independently correlated with IDH. BNP had a predictive value for the occurrence of IDH. Conclusions: BNP showed predictive value for IDH and may serve as a useful predictor of this complication. Its independent association with IDH supported its potential utility in clinical decision-making.