| Theme | Blood Pressure Control in Chronic Renal Failure | |
|---|---|---|
| Title | Dialysis induced hypotension | |
| Publish Date | 1997/09 | |
| Author | Kaoru Tabei | Department of Nephrology, Jichi Medical School |
| [ Summary ] | Hypotension in chronic dialysis patients includes sustained hypotension and dialysis-induced-hypotension. Sustained-hypotension is frequently seen in long-term hemodialys is patients who were hypertensive in the early hemodialysis period. The etiology of sustained-hypotension in long-term hemodialysis patients includes; 1) poor vascular response to vasoactive substances, 2) inappropriate cardiac functional reserve. On the other hand, dialysis-induced-hypotension is caused by; 1) reduced circulating blood volume due to water removal, caused mainly by inappropriate plasma refilling, 2) autonomic nervous dysfunction, 3) acetate intolerance, 4) poor biocompatibility with the dialyzer membrane, 5) hypoglycemia. Sustained-hypotension is usually treated with pharmaceutical agents. To prevent dialysis-induced-hypotension, the dry weight setting should be considered carefully, using echocardiography, In most cases, several dialysis maneuvers, such as ECUM, HDF, hypernatremic dialysis, and low temperature dialysis, can prevent dialysis-induced-hypotension. Patients with autonomic dysfunction are treated with pharmaceutical agents. |
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