الفهرس | Only 14 pages are availabe for public view |
Abstract Intradialytic hypotension is considered a big obstacle as it interfere with- continuation of haemodialysis cession or interrupte the haemodialysis cession decreasing its efficacy.In patients with end stage renal disease (ESRD) on regular haemodialysis (HD), the maintenance of fluid status is optimally critical to avoid circulatory complications.Chronic volume overload may contribute to the increase of overall cardiovascular mortality, where volume under load may lead to symptoms of volume depletion. Thus, the dialysis prescription attempts to bring patients into optimal fluid status.One of the common clinical manifestations of haemodynamic instability during haemodialysis is hypotension. The incidence of a symptomatic reduction in blood pressure during haemodialysis is in the range of 15%-50% This problem contributes to excessive morbidity associated with the procedure.Dialysis-induced hypotension is still an important problem of hemodialysis treatment that may complicate up to one-third of dialysis sessions, reviews note that the critical issue is the decrease in blood volume induced by ultrafiltration.Clinically, two types of dialysis-induced hypotension have been recognized. The first is a relatively asymptomatic gradual reduction in blood pressure accompanied by an increase in heart rate, the second a more abrupt and severe fall in blood pressure associated with bradycardia and symptoms such as cramps, nausea, and vomiting.Acute intradialysis hypotension is an important complication of chronic haemodialysis, occurring in 20-35% of patients. The main causes of haemodialysis-induced hypotension are thought to be acute hypovolaemia during ultrafiltration and inadequate compensatory mechanisms, such as left ventricular systolic and diastolic dysfunction, inappropriate plasma refilling and abnormal arterial and venous compliance. |