What is Intradialytic hypertension?

Background. Intradialytic hypertension is an increase in blood pressure from pre to post hemodialysis that has recently been identified as an independent mortality risk in hypertensive hemodialysis patients.

How do you manage Intradialytic hypertension?

Prevention and treatment of intradialytic hypertension may include careful attention to dry weight, avoidance of dialyzable antihypertensive medications, limiting the use of high calcium dialysate, achieving adequate sodium solute removal during hemodialysis, and using medications which inhibit the rennin-angiotensin- …

Why does intradialytic hypotension occur?

Intradialytic hypotension can result from various causes, including rapid fluid removal in an attempt to attain “dry weight,” particularly among those with large interdialytic weight gains; diminished cardiac reserve and intake of medications that alter cardiovascular stability, and use of low-sodium dialysate or …

What is the intradialytic hypotension?

Intradialytic hypotension (IDH) is associated with disabling symptoms, underdialysis, vascular access thrombosis, accelerated loss of renal function, cardiovascular events, and mortality [1, 2, 3]. The prevalence of IDH depends on the definitions that are used.

What does Intradialytic mean?

Adjective. intradialytic (not comparable) (medicine) carried out, or occurring, during dialysis (of blood)

How is intradialytic hypotension prevented?

Increasing the treatment time to at least 4 h three times a week and limiting dialysate and dietary sodium intake are effective ways to reduce IDH. Ultrafiltration profiling needs further work, but it appears that removing more fluid during the first hour of dialysis and reducing the rate later on may also reduce IDH.

What is the immediate treatment of intradialytic hypotension?

A symptomatic reduction in BP during or immediately after dialysis occurs in approximately 20 to 30% of dialysis sessions. The treatment includes stopping or slowing the rate of ultrafiltration, placing the patient in the Trendelenburg position, decreasing the blood flow rate, and restoring intravascular volume.

What are Intradialytic symptoms?

Common intradialytic symptoms include muscle cramps, pruritus, headaches, nausea, and fatigue. Symptomatic hypotension occurs in up to 30% of patients during hemodialysis and patients may cut short their dialysis sessions because of intradialytic symptoms.

How is intradialytic hypotension treated?

Which is immediate treatment of intradialytic hypotension?

Cooling the dialysate reduces the rate of intradialytic hypotension by 7.1 times when compared with conventional therapy. Most studies have used a fixed reduction in dialysis temperature from 37 to 35°C.

How can Intradialytic complications be prevented?

Increasing the treatment time to at least 4 h three times a week and limiting dialysate and dietary sodium intake are effective ways to reduce IDH.

What is Intradialytic complication?

Although HD is generally a safe procedure, acute intradialytic complications are frequently encountered. The most commonly associated complications include hypotension, muscle cramps, nausea and vomiting, headache, pruritus, fever and chills. Many of the complications are associated with hypotension.