Review Articles: Approach to Patients with Intradialytic Hypotension: A Focus on Therapeutic Options

Perazella, Mark A.

doi:10.1046/j.1525-139x.1999.99013.x

Cited by 23 publications

(20 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition, IDH often requires the administration of fluids (3) or the early discontinuation of dialysis, both of which may prevent adequate fluid removal (3,4). Patients with IDH may ultimately experience the effects of volume overload and chronic underdialysis (5).…”

mentioning

confidence: 99%

A Randomized, Controlled Trial of Albumin versus Saline for the Treatment of Intradialytic Hypotension

Knoll¹,

Grabowski²,

Dervin³

et al. 2004

Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Abstract. Intradialytic hypotension (IDH) is the most common complication of hemodialysis. Symptomatic IDH requires the administration of fluid and often results in the early termination of dialysis, both of which may prevent adequate fluid removal. The optimal fluid for the treatment of IDH remains unknown. A randomized, double-blind, crossover trial was performed in 72 chronic hemodialysis patients to determine whether 5% albumin was more effective than normal saline for the treatment of IDH. The primary outcome measure was the percentage of target ultrafiltration achieved, which was defined as the actual ultrafiltration volume divided by target ultrafiltration volume. Secondary outcome measures included postdialysis BP, time to restore BP, recurrent IDH, and treatment failure (inability to restore BP with 750 ml of study fluid). The percentage of target ultrafiltration achieved was 0.84 Ϯ 0.17 for 5% albumin compared with 0.80 Ϯ 0.16 for saline (P ϭ 0.14). The postdialysis systolic BP (121 Ϯ 19 mmHg versus 117 Ϯ 19 mmHg; P ϭ 0.32), postdialysis diastolic BP (63 Ϯ 9 mmHg versus 61 Ϯ 9 mmHg; P ϭ 0.33), volume of study fluid used to treat IDH (403 Ϯ 170 ml versus 428 Ϯ 191 ml; P ϭ 0.34), time required to restore the BP (7.9 Ϯ 6.6 min versus 9.9 Ϯ 7.5 min; P ϭ 0.09), total nursing time required to manage the hypotensive episode (15.1 Ϯ 7.2 min versus 15.9 Ϯ 7.3 min; P ϭ 0.47), number of treatment failures (22% versus 24%; P ϭ 1.0), and the frequency of recurrent IDH (36% versus 36%) were not significantly different when 5% albumin was used compared with saline. It is concluded that 5% albumin is no more effective than normal saline for the treatment of IDH in chronic hemodialysis patients. Normal saline should be used as the initial fluid for the treatment of IDH.

show abstract

mentioning

confidence: 99%

A Randomized, Controlled Trial of Albumin versus Saline for the Treatment of Intradialytic Hypotension

Knoll¹,

Grabowski²,

Dervin³

et al. 2004

Journal of the American Society of Nephrology

View full text Add to dashboard Cite

show abstract

“…In a na ti o nal samp le con sis ting of 4500 di aly sis pa ti ents, it was fo und that the pre sen ce of a low pre di aly sis systolic blo od pres su re (less than 100 mmHg) was sig nifi cantly re la ted to in cre a sed mor ta lity ra te (re la ti ve risk of 1.86). 10 When com pa red to yo un ger HD pati ents, par ti cu larly in the presence of di a be tes melli tus, left ven tric le hyper trophy and se ve re Turkiye Klinikleri J Med Sci 2011;31 (6) con ges ti ve he art fa i lu re, the el derly ha ve im pa i red car di o pul mo nary/pres sor re cep tor ref lex func tion. [11][12][13] Furt her mo re, chro ni cally hypo ten si ve in divi du als un der go ing HD the rapy ex hi bi ted a sig ni fi cant down-re gu la ti on in alp ha and be ta ad rener gic re cep tors, sug ges ting an ina bi lity to pro duce an ade qu a te sympat he tic res pon se.…”

Section: Discussionmentioning

confidence: 99%

“…Turkiye Klinikleri J Med Sci 2011;31 (6) STA TIS TI CAL ANALY SIS Sta tis ti cal analy ses we re per for med by SPSS sta tisti cal soft wa re (10.0 ver si ons, SPSS, Cary, NC, USA). All re sults are ex pres sed as me an ± SD (stan dard devi a ti on).…”

Section: Methodsmentioning

confidence: 99%

“…5 The re are two com mon types of HD-as so ci ated hypo ten si on. 6 One typi cally oc curs du ring the la ter sta ges of HD; the ot her is a chro nic, per sistent form of hypo ten si on. The lat ter has be en esti ma ted to affect ap pro xi ma tely 5-10% of the di aly sis patients and be co mes even mo re pre valent in long-term HD pa ti ents es pe ci ally in tho se with di a be tes.…”

mentioning

confidence: 99%

See 1 more Smart Citation

The Effect of Midodrine Hydrochloride on Chronic Hypotension in Patients with Diabetes Mellitus Undergoing Hemodialysis Therapy

Sarikaya¹,

Sarı²,

Güneş³

2011

Turkiye Klinikleri J Med Sci

View full text Add to dashboard Cite

A AB BS S T TR RA AC CT T O Ob b j je ec c t ti i v ve e: Chro nic hypo ten si on is a com mon comp li ca ti on of he mo di aly sis in pa ti ents with di a be tes mel li tus. Mi dod ri ne hydroch lo ri de is an alp ha-1 ago nist that ef fec ti vely cor rects intra di aly tic hypo ten si ve at tacks. However, the ef fect of mi dod ri ne on chro nic hypo ten si on is still unk nown in he mo di aly sis pa ti ents. In the pre sent study, we ai med to eva lu a te the ef fects of mi dod ri ne tre at ment on chro nic hypo ten si on in pa ti ents with di a be tes mel li tus undergoing he mo di aly sis. M Ma a--t te e r ri i a al l a an nd d M Me et t h ho od ds s: A to tal of 21 di a be tic pa ti ents un der go ing he mo di aly sis and had chro nic hypo ten si on (systo lic blo od pres su re <100 mmHg be fo re di aly sis) we re inc lu ded in the study. Mi dod ri ne was given 5 mg p.o. twi ce a day and 5 mg be fo re every di aly sis ses si on to all pa ti ents. Blo od pres su res (pre-he mo di aly sis systo lic, di as to lic and me an ar te ri al pres su re) we re me a su red. In tra-di aly tic hypo ten si on at tacks, ort hos ta sis, diz zi ness, fa ti gu e, blur red vi si on, dull ness, and he a dac he we re re cor ded. Da ta ob ta i ned be fo re mi dod ri ne the rapy we re com pa red to tho se collec ted at the 3 rd month of he mo di aly sis when the patients were under mi dod ri ne the rapy. R Re e s su ul lt ts s: : Pre-di aly sis systo lic, di as to lic and me an ar te ri al blo od pres su res, ver ti go and synco pe at tacks were sig ni fi cantly (p< 0.05) im pro ved by mi dod ri ne the rapy. No sig ni fi cant dif fe ren ce was se en in mean ul tra-fil tra ti on vo lu me per he mo di aly sis ses si on and num ber of in tra-di aly tic hypo ten si ve at tacks ac cor ding to ba se li ne va lu es over the co ur se of study (p>0.05). C Co on nc c l lu u s si i o on n: : Mi dod ri ne ap pe ars to be an ef fec ti ve and sa fe tre at ment op ti on in di a be tic he mo di aly sis pa ti ents with sympto ma tic chro nic hypo ten si on, but it has no ef fect on in tra-di aly tic hypo ten si ve at tacks. K Ke ey y W Wo or rd ds s: : Di a be tes mel li tus; hypo ten si on; re nal di aly sis; Mi dod ri ne Ö ÖZ ZE ET T A Am ma aç ç: Kro nik hi po tan si yon di ya bet li has ta lar da he mo di ya li zin sık gö rü len bir komp li kasyo nu dur. Mi dod rin hid rok lo rid di ya liz sı ra sın da ki hi po tan sif atak la rı et ki li şekil de dü zel ten al fa-1 ago nist bir ilaç tır. Fa kat he mo di ya liz has ta la rın da mi dod ri nin kro nik hi po tan si yon da ki et ki si ha len bi lin me mek te dir. Bu ça lış ma da mi dod rin te da vi si nin he mo di ya liz te da vi si alan di ya bet has ta la rın -da kro nik hi po tan si yo na et ki le ri ni de ğer len dir me yi amaç la dık. G Ge e r re eç ç v ve e Y Yö ön n t te em m l le er r: Kro nik hi potan si yo nu olup (di ya liz den ön ce sis to lik kan ba sın cı <100 mmHg) he mo di ya liz te da vi si alan top lam 21 di ya be tik has ta ça lış ma ya alın dı. Tüm has ta la ra gün de iki kez ...

show abstract

“…1 Rizik od razvoja intradijalizne hipotenzije Povećan rizik od razvoja intradijalizne hipotenzije imaju bolesnici koji se leče hemodijalizom sa: dijabetesnom nefropatijom (dijabetesna polineuropatija), bolestima srca (hipertrofija leve komore, poremećaj dijastolne funkcije leve komore, hronična zastojna srčana slabost, perikardni izliv), lošim nutritivnim statusom (hipoalbuminemija), uremijskom polineuropatijom, autonomnom disfunkcijom, velikim interdijaliznim prinosom (Interdialytic Weight Gain -IDWG > 5%), velikom stopom ultrafiltracije (Ultrafiltration -UF ≥ 10 ml/kg/h) i predijaliznim sistolnim krvnim pritiskom manjim od 100 mmHg. 1,5 Patogeneza intradijalizne hipotenzije Patogeneza intradijalizne hipotenzije je složena i višefaktorska. Ona uključuje faktore povezane sa procesom hemodijalize (stopa ultrafiltracije, temperatura rastvora za hemodijalizu, koncentracija natrijuma i kalcijuma u rastvoru za hemodijalizu) i faktore povezane sa bolesnikom (hipertrofija leve komore, poremećaj dijastolne ili sistolne funkcije leve komore, perikardni izliv, poremećaj funkcije autonomnog nervnog sistema: uremijska i/ili dijabetesna polineuropatija).…”

Section: Uvodunclassified

Intradialytic hypotension: Clinical consequences and basic prevention principals

Petrović¹

2015

PONS

View full text Add to dashboard Cite

Review Articles: Approach to Patients with Intradialytic Hypotension: A Focus on Therapeutic Options

Cited by 23 publications

References 41 publications

A Randomized, Controlled Trial of Albumin versus Saline for the Treatment of Intradialytic Hypotension

A Randomized, Controlled Trial of Albumin versus Saline for the Treatment of Intradialytic Hypotension

The Effect of Midodrine Hydrochloride on Chronic Hypotension in Patients with Diabetes Mellitus Undergoing Hemodialysis Therapy

Intradialytic hypotension: Clinical consequences and basic prevention principals

Contact Info

Product

Resources

About