The Japanese Journal of Clinical Dialysis Vol.24 No.4(2-3)

Theme Current Problem of Clinical Studies in Dialysis Therapy
Title Dialysis-related hypotension
Publish Date 2008/04
Author Ryota Ikee Department of Nephrology and Kidney and Dialysis Center, Shonan Kamakura General Hospital
Author Shuzo Kobayashi Department of Nephrology and Kidney and Dialysis Center, Shonan Kamakura General Hospital
[ Summary ] Dialysis-related hypotension, a frequent complication in clinical practice of hemodialysis, is attributable to several causes, such as cardiac complications, autonomic dysfunction, hypoalbuminemia, anemia, inappropriate dry weight, low dialyzer biocompatibility, antihypertensive drugs, and increased endotoxin concentrations in dialysis fluids. Cardiac complications are important, because they are associated with high mortality rates for dialysis patients. In addition, it should be noted that a substantial percentage of asymptomatic patients have coronary artery stenosis, as proven by coronary angiography at the initiation of dialysis. The assessment of appropriate dry weight is another important problem. Although there is no standardized method to determine appropriate dry weight to date, bioelectrical impedance analysis, which can evaluate extracellular volume, intracellular water, and total body water, seems to be a promising method.
back