目的 了解绵竹地区慢性肾脏病(chronic kidney disease， CKD)5期患者首次血液透析时临床情况，从而提供持续改进透析前CKD管理的依据。 方法 采用单中心回顾性研究，纳入2014年1月～2019年12月在绵竹市人民医院进行首次血液透析(hemodialysis，HD)的CKD 5期患者，按有无高血压分为高血压组和正常血压组，记录患者进入HD时的基本情况，比较2组患者首次HD时的实验室指标、原因及血管通路。 结果 共185例患者纳入本研究，排名前3的原发病是慢性肾小球肾炎(79例)、糖尿病肾病(61例)及高血压肾损害(22例)，排名前3的并发症是肾性贫血(178例)、高血压(171例)及肾性骨病(104例)。2组患者进入透析的原因均以尿毒症症状为主，2组比较无统计学差异(χ2=2.937,P=0.087)。2组患者进入透析时正常血压组的血磷高于高血压组(t=-1.990,P =0.048),高密度脂蛋白胆固醇低于高血压组(t=2.070,P=0.040)。首次进入血液透析时，2组患者在血管通路方面无统计学差异(χ2=0.000,P=0.985)。 结论 慢性肾小球肾炎为绵竹地区CKD 5期首次血液透析患者的首位原发病。尿毒症症状是首次血液透析最常见原因，肾性贫血、高血压及肾性骨病是首次血液透析最常见并发症。

Objective  To understand the clinical situation of patients with stage 5 chronic kidney disease (CKD) during the first hemodialysis in Mianzhu area, so as to provide a basis for continuous improvement of CKD management before dialysis.  Methods  A single-center retrospective study was performed, which recruited patients with stage 5 CKD and undergoing first hemodialysis (HD) in Mianzhu People's Hospital from January 2014 to December 2019. They were divided into hypertension group and normal blood pressure group. Their clinical data at the first hemodialysis were recorded. Laboratory indicators, primary renal disease, and dialysis access modality were compared between the two groups.   Results   A total of 185 patients were included in this study. The top 3 primary diseases were chronic glomerulonephritis (79 cases), diabetic nephropathy (61 cases) and hypertensive renal damage (22 cases); the top 3 complications were renal anemia (178 cases), hypertension (171 cases) and renal osteopathy (104 cases). The main reasons for hemodialysis were uremic symptoms, similar in both groups (χ2=2.937, P=0.087). Serum phosphorus was higher in normal blood pressure group than in hypertension group (t=-1.990, P=0.048), while serum high-density lipoprotein cholesterol was lower in the normal blood pressure group than in hypertension group (t=2.070,   P=0.040). Blood access modality had no difference between the two groups (χ2=0.000, P=0.985).  Conclusion  Chronic glomerulonephritis was the most important primary disease in stage 5 CKD patients at first hemodialysis in Mianzhu area. Uremic symptoms were the most common causes for the beginning of hemodialysis. Renal anemia, hypertension, and CKD-mineral and bone disorder (CKD-MBD) were the most common complications in these patients.