Relationship between serum PTH, potassium (K+), calcium (Ca2+), blood phosphate (PO4), parathyroid hormone (PTH), albumin (ALB) levels and orthostatic hypotension in hemodialysis patients

Background: Orthostatic hypotension (OH) in maintenance hemodialysis (MHD) patients is a frequent chronic complication. OH may lead to inadequate dialysis, cardiovascular complications, and death. This study explored the relationship between OH and various factors, including serum levels of parathyroid hormone (PTH), potassium (K+), calcium (Ca2+), blood phosphate (PO4), albumin (ALB) levels and Orthostatic Hypotension in Hemodialysis Patients. Methods: 121 MHD patients were enrolled, and their clinical data were acquired. They were categorised into a control (Ctrl) group (normal patients) and an observation (Obs) group (OH patients) based on the diagnostic criteria for OH. Differences in clinical data between patients in different groups were compared, and binary logistic regression (BLR) analysis was performed to assess contributing factors. Results: Among 121 MHD patients, 40 (33.06%) experienced OH. Comparative analysis demonstrated that patients in the OH group were significantly older, had higher supine systolic blood pressure, increased prevalence of diabetes, and elevated PTH levels, with concomitantly lower blood pressure responses at 1 and 3 minutes after standing, as well as reduced ALB and triglyceride levels (P<0.05). Binary logistic regression analysis further identified advanced age and comorbid diabetes as independent risk factors, whereas higher ALB levels were independently protective against OH. Conclusions: This study confirms a relatively high incidence of OH in MHD patients and underscores that advanced age, diabetes, and low serum albumin levels are significant independent predictors of OH. These findings suggest that early identification and targeted intervention in high-risk patients could improve hemodialysis outcomes and reduce cardiovascular complications.