Intradialysis hypotension: causes and sequelae


Aim. To study causes and sequelae of intradialysis hypotension (IH) in patients with terminal renal
failure (TRF).
Material and methods. Forty one patients with TRF on chronic hemodialysis (CH) were divided into
two groups. The study group consisted of 24 patients with episodes of IH. Seventeen patients of the
control group had no IH. All the patients were examined with assessment of protein-energy deficiency
residual renal function, left-ventricular hypertrophy, diastolic function of the heart. Hemodialysis effectiveness
was estimated by Kt/V index. Survival of the patients was calculated according to Kaplan-Meier
Results. In the study group IH episodes occurred in spite of low ultrafiltration velocity (8-10 ml/min).
Those patients of the study group who had IH associated with polyneuropathy and left-ventricular
hypertrophy had IH episodes more often and sharper falls of arterial pressure. Long-term IH decreased
survival significantly.
Conclusion. Repeated episodes of IH deteriorate effectiveness of hemodialysis because of acute coronary
syndrome, acute disorder of cerebral circulation, complications of deficient dialysis syndrome
(pericarditis, hyperkaliemia, pulmonary edema, congestive heart failure).


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Abstract - 76


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