Effects of Dialysis Room Noise Exposure on Plasma Renin Activity, Angiotensin II, and Blood Pressure Fluctuations in Patients Undergoing Maintenance Hemodialysis

OBJECTIVE: To investigate the effects of environmental dialysis room noise exposure on plasma renin activity (PRA), angiotensin II (Ang II) levels, and blood pressure fluctuations in patients undergoing maintenance hemodialysis (MHD). METHODS: This retrospective study included 100 patients receiving MHD at Cixi People's Hospital, Wenzhou Medical University, between May 2020 and November 2022. According to the average noise level of their dialysis shifts, patients were divided into a high-exposure group (>55 dB(A)) and a low-exposure group (≤55 dB(A)), with 50 cases each. Repeated-measures analysis of variance and multivariable linear regression were performed. RESULTS: At 3 and 6 months, the high-exposure group had significantly higher PRA and Ang II levels, greater systolic and diastolic blood pressure (DBP) fluctuation ranges, and a higher incidence of intradialytic hypertension compared with those in the low-exposure group (all P < 0.05). Multivariable linear regression showed that noise exposure level was independently positively associated with PRA ( β = 0.63, 95% confidence interval [CI]: 0.41-0.86), Ang II ( β = 13.35, 95% CI: 9.10-17.59), systolic blood pressure fluctuation range ( β = 7.03, 95% CI: 5.06-9.01), and DBP fluctuation range ( β = 3.49, 95% CI: 2.24-4.74), all P < 0.001. CONCLUSION: Higher dialysis room noise exposure was associated with activation of the renin-angiotensin system, increased blood pressure fluctuations, and higher risk of intradialytic hypertension. Optimizing the acoustic environment may improve hemodynamic stability in patients undergoing MHD.