| Theme | Abnormal Blood Pressure in Dialysis Patients | |
|---|---|---|
| Title | Management of dialysis related hypotension | |
| Publish Date | 2011/08 | |
| Author | Yoshiharu Tsubakihara | Department of Kidney Disease and Hypertension, Osaka General Medical Center |
| [ Summary ] | Dialysis related hypotension (DRH) is one of the most common complications experienced by hemodialysis (HD) patients. DRH is not only related to intradialytic hypotension (IDH), but sustained hypotension and orthostatic hypotension (OH) experienced by after HD session. Generally, IDH is treated with cumbersome and complicated means during HD sessions. However, for HD patients, treatment for OH after HD sessions is a serious problem, leading to impaired ADL and QOL. Survival rates for IDH patients may also suffer. The primary factor concerning IDH or OH is ultrafiltration rates during HD. Restriction of sodium and fluid intake is the most important prophylactic action. Normal saline infusion is the most useful therapy for DRH. Failure of the sympathetic nervous system is also a major concern for DRH patients. Therefore, refractory cases should be treated with sympathicomimetic drugs such as amezinium metilsulfate or droxidopa. |
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