Abstract: Background Chronic hypotension state correlates closely with the quality of life in patients on maintenance dialysis.Our previous study found that abnormal nutrient metabolism and the persistence of micro-inflammatory state are important contributing factors.Objective To observe the effect of compound α-ketoacid plus antioxidant on maintenance hemodialysis MHD related hypotension.Methods Fifty-two MHD patients with chronic hypotension were randomly divided into 2 groups.In control group,patients were treated with hemodialysis,Levocarnitine and Gutron.In treatment group,additional compound α-ketoacid and antioxidant（Probucol）were added.The course of treatment was 6 months.Patients’ baseline blood pressure during hemodialysis was observed and their dry weight,arm muscle circumference（AMC）,modified SGA score,albumin（ALB）,hemoglobin（Hb）,C reactive protein（CRP）and hemodialysis sufficiency（Kt/V）were determined.Results At baseline,all indexes in both groups showed no significant difference（P ＞0.05）.After treatments,blood pressures in both groups increased significantly（P ＜0.05）.Compared to control group,blood pressure in the treatment group increased more signifcantly（P ＜0.05）.In addition,compared to baseline,in treatment group,dry weight and AMC increased significantly（P ＜0.05）;modified SGA score decreased significantly（P ＜0.05）,while the control group showed no differences.The differences in these indexes between control and treatment group were statistically significant（P ＜0.05）.Compared to baseline,neither group showed significant difference in ALB and Hb（P ＞0.05）.At the end of this study,treatment group showed significant lower level of CRP（P ＜0.05）and significant higher Kt/V than control（P ＜0.05）.Conclusion By regulating the nutrition,metabolism and the status of micro-inflammation compound α-ketoacid plus antioxidant can treat the chronic hypotension effectively and improve the quality of hemodialysis for MHD patients.BG)W