Management of acute intradialytic cardiovascular complications: Updated overview (Review)

Abstract

An increasing number of patients require renal replacement therapy through dialysis and renal transplantation. Chronic kidney disease (CKD) affects a large percentage of the world's population and has evolved into a major public health concern. Diabetes mellitus, high blood pressure and a family history of kidney failure are all major risk factors for CKD. Patients in advanced stages of CKD have varying degrees of cardiovascular damage. Comorbidities of these patients, include, on the one hand, hypertension, hyperlipidemia, hyperglycemia, hyperuricemia and, on the other hand, the presence of mineral-bone disorders associated with CKD and chronic inflammation, which contribute to cardiovascular involvement. Acute complications occur quite frequently during dialysis. Among these, the most important are cardiovascular complications, which influence the morbidity and mortality rates of this group of patients. Chronic hemodialysis patients manifest acute cardiovascular complications such as intradialytic hypotension, intradialytic hypertension, arrhythmias, acute coronary syndromes and sudden death. Thus, proper management is extremely important.

Exploring the relation between Interleukin-6 and high-sensitive cardiac troponin T in asymptomatic hemodialysis patient: A cross-sectional study

“…Rapid changes in blood pressure during dialysis treatment are considered a risk factor for IHD. Intradialytic ultrafiltration causes hypotension and a decrease in venous return with a subsequent increase in the stretching of the heart without compensation, particularly in patients with chronic dialysis and heart failure, which leads to myocardial ischemia due to hypoperfusion [ 39 ], thus higher troponin levels.…”

Aboriginal Bacterial Flora in the Uricase-Deficient Rat Gut is Not the Main Factor Affecting Serum Uric Acid

“…Bacteria are an essential part of microecology in the gut. They are also regarded as a concerned factor affecting multiple aspects of health, including diabetes mellitus, hypertension, and hyperlipidemia [ 14 ]. Bacteria might contribute to hyperuricemia because it has been shown that inoculated engineered bacteria lowered SUA levels [ 8 ].…”

“…Bacteria are an essential part of microecology in the gut. ey are also regarded as a concerned factor affecting multiple aspects of health, including diabetes mellitus, hypertension, and hyperlipidemia [14]. Bacteria might Figure 2: Food and water intake and urine and stool output of the male Uox -/rats treated with antibiotics for 5 days (mean + SD, n � 6).…”

Heart Rate Variability and Long Chain n-3 Polyunsaturated Fatty Acids in Chronic Kidney Disease Patients on Haemodialysis: A Cross-Sectional Pilot Study

“…Arrhythmias and cardiac arrests account for over a quarter of deaths among haemodialysis patients [22] and the first three months following commencement of haemodialysis treatment are particularly high-risk for SCD due to factors relating to the parameters of the dialysis itself that may trigger arrhythmia, but also the high prevalence of pre-existing cardiovascular disease and diabetes [23]. This study set out to characterise erythrocyte membrane and plasma LC n-3 PUFA in a UK patient population who have recently commenced haemodialysis, as well as exploring relationships with HRV parameters during this critical period in their treatment.…”