Novel Insights into the Pathogenesis and Prevention of Intradialytic Hypotension

Frank M. van der Sande*, Marijke J. Dekker, Karel M. L. Leunissen, Jeroen P. Kooman

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

17 Citations (Web of Science)

Abstract

Background: Intradialytic hypotension (IDH) is a common complication of haemodialysis (HD) and associated with adverse outcomes, especially when a nadir definition (systolic blood pressure <90 mm Hg) is used. The pathogenesis of IDH is directly linked to the discontinuous nature of the HD treatment, in combination with patient-related factors such as age, diabetes mellitus and cardiac failure. Summary: Although the decline in blood volume due to removal of fluid by ultrafiltration is the prime mover, thermally induced reflex vasodilation compromises the haemodynamic response to hypovolemia. Recent studies have stressed the relevance of changes in tissue perfusion during HD, which may translate in long-term organ damage. Monitoring changes in tissue perfusion, for which emerging evidence becomes available, appears to have great promise in the fine-tuning of the dialysis procedure. Key Messages: While it is unlikely that IDH can be completely prevented, reduction in inter-dialytic weight gain, prevention of an increase in core temperature by adjusting the dialysate temperature and more frequent or prolonged dialysis treatment remain cornerstones in providing a more comfortable and safe treatment. (c) 2018 S. Karger AG, Basel
Original languageEnglish
Pages (from-to)230-235
Number of pages6
JournalBlood Purification
Volume45
Issue number1-3
DOIs
Publication statusPublished - 1 Jan 2018
EventRenal-Research-Institute's 20th International Conference on Dialysis, Advances in Chronic Kidney Disease (CKD) - Lake Buena Vista, FL, Lake Buena Vista
Duration: 1 Jan 2018 → …

Keywords

  • Dialysis
  • Prevention
  • New insights
  • Hypotension
  • HIGH-FLUX HEMODIALYSIS
  • BLOOD-PRESSURE
  • DIALYSIS
  • HEMODIAFILTRATION
  • ULTRAFILTRATION
  • TEMPERATURE
  • MORTALITY
  • VOLUME
  • CARDIOMYOPATHY
  • HEMODYNAMICS

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