Assessment of hypotension during dialysis as a manifestation of myocardial ischemia in patients with chronic renal failure

Hassan²,

Anwer Khan Mod Med Coll J

et al. 2017

Background: Hypotension during hemodialysis is common. In some patients, the development of hypotension necessitates intravenous fluid replacement before patients are able to safely leave the dialysis unit. Intradialytic hypotension may reduce the efficacy of the dialysis procedure and contributes to the excessive morbidity and mortality that is associated with hemodialysis. Aims:The aim of the study is to identify the patients who develops intradialytic hypotension and find out the aetiology, risk factors and outcome to reduce the mortality and morbidity of those patients.Methodology: This Cross sectional descriptive type of observational study was conducted in the Haemodialysis Unit of Anwer Khan Modern Medical College Hospital over the period from January 2015 to December 2016. The change in systolic pressure during haemodialysis was reviewed for ten consecutive haemodialysis in all the patients. The patients with chronic renal failure who were on regular dialysis were enrolled. Patients with sepsis, hemoglobin level less than 9 g/dL, low cardiac output, acute coronary syndrome, significant valvular lesion or body weight below the dry weight of the patient were excluded from the study.Result: Ninetythree patients were included in the study. Among them male 53(56.98%) and female 40(43.02%) with a M:F ratio was 1.3:1. The mean age of the patients was 53.50±16.82 (Range 13-90).We found that 28%(26) of the patients developed intradialytic hypotension at least once in consecutive ten dialysis. Out of them 14 were female and 12 patients were male. All of the patients recovered from the incident after adequate management and stoppage of the ultrafiltrate volume, convert the machine to SLED(Sustained low efficacy dialysis) mode and hold antihypertensive drugs morning dose on the day of haemodialysis and treatment of the cause. Conclusion:As a result of increasing age of the patients receiving hemodialysis and the increasing incidence of diabetic nephropathy, hypotension will become a greater problem in future.Key Words: Hypotension, Haemodialysis ABSTRACT necessitates intravenous fluid replacement before patients are able to safely leave the dialysis unit.

Section: Discussionmentioning

confidence: 63%

Hypotension During Haemodialysis: Aetiology, Risk Factors and Outcome

Hassan²,

Anwer Khan Mod Med Coll J

et al. 2017

“…The relevance of the physiotherapeutic intervention in the pain is also referred in the studies of Soliman et al [22] and Lima et al [23], in which the patients with CRF complain frequently about discomfort and pain, mainly in the lumbar and cervical region, that can be explained by many reasons, such as: presence of musculoskeletal disorder, remaining in seated and static position, and standard chairs which do not respect the ergonomic individualities of each patient.…”

Section: Resultsmentioning

confidence: 96%

Benefits of intradialytic physiotherapy in quality of life, pain, edema and respiratory function of patients with chronic kidney disease

et al. 2018

Introduction: Patients with chronic kidney disease suffer from a decline in quality of life and respiratory function, for various reasons related to this condition. Objective: To verify the influence of intradialytic physiotherapy on the quality of life and respiratory function in chronic renal patients. Methods: The sample was non-probabilistic and consisted of 51 individuals, of both sexes, aged between 30 and 60 years. The WHOQOL-Bref, an evaluation form, the Manovacuometer and Peak Flow were used to detect the impact of the physiotherapeutic intervention before and after an eight-week treatment protocol. Results: There was a difference in the comparison of the general QOL before and after (p = 0.006) the intervention, as well as in the improvement of the maximal forced expiratory flow peak (p = 0.001), the PEmax (p = 0.000), peak forced expiratory flow rate (0.017) and pain (p = 0.006). There was also improvement of edema (p = 0.013) and cramps (p = 0.000). Conclusion: The benefits of intradialytic physiotherapy in improving QOL and respiratory function in chronic kidney patients are explicit.

“…Yapılan çalışmalarda UF ile İDH arasında doğru orantılı bir ilişki olduğu bulunmuştur (5). Diyaliz seansında 2 ila 4 litre arasında yapılan UF vücut kan hacminin yaklaşık olarak %40-60 oluşturması nedeni ile hipotansiyon gelişmesi çok da şaşırtıcı bir durum değildir (25). Ayrıca diyaliz solüsyonunun 37 o C ve daha sıcak olması damarlarda vazodilatasyona neden olur ve hastada hipotansiyon gelişebilir.…”

Section: İntradiyalitik Hipotansiyonunclassified

İntradiyalitik Besin Alımı ve İntradiyalitik Hipotansiyon

Avci¹,

Arıkan²

2020

ndthdt

İntradiyalitik hipotansiyon diyaliz sırasında en sık karşılaşılan komplikasyonlardan biridir. Hemodiyaliz hastaları için büyük bir problem olan intradiyalitik hipotansiyonun, diyaliz sırasında besin alımı ile ilişkili olduğu ifade edilmekle birlikte hipoglisemi, malnütrisyon, ek besin sağlama gibi nedenlerden dolayı intradiyalitik beslenmenin ülkemizde ve dünyada desteklendiği bilinmektedir. Diyaliz sırasında hastaların yemek yemesine izin verilmesi hala tartışmalıdır ve diyaliz merkezlerinde intradiyalitik beslenme konusunda çeşitli uygulamalar mevcuttur. Bu derlemede intradiyalitik hipotansiyon, intradiyalitik hipotansiyonun beslenme ile ilişkisi, önleme, tedavi ve hemşirelik yaklaşımları konusunda bilgilere yer verilmiştir.