Abstract
Objective
To investigate the association between limb ischemic preconditioning (LIPC) and intradialytic hypotension (IDH) in patients with diabetic kidney disease (DKD) undergoing maintenance hemodialysis (MHD).Methods
This single-center retrospective cohort study consecutively enrolled 112 patients with DKD receiving MHD at our institution between January and December 2023. Among them, 50 patients were assigned to the LIPC group and 62 to the control group. The incidence of IDH, blood pressure trends, clinical interventions, and the occurrence of major adverse cardiovascular events (MACE) were compared between groups. Considering the potential intra-individual correlation across repeated dialysis sessions, a generalized linear mixed model (GLMM) was used to identify independent risk factors for IDH, with each dialysis session as the unit of analysis and patient-specific random intercepts included.Results
The overall incidence of IDH in the LIPC group was 7.1% (4.7-8.8), significantly lower than 11.8% (6.6-30.0) in the control group. The frequency of IDH episodes across all time intervals (0-1 h, 1-2 h, 2-3 h, and 3-4 h) was significantly lower in the LIPC group (all P Conclusions
LIPC use was associated with a significantly lower incidence of IDH in DKD patients undergoing MHD and attenuated blood pressure decline, with a favorable safety profile.