肾脏病学与治疗学杂志

Incidence and Measures to Prevent Intradialytic Hypotension in Patients on Maintenance Hemodialysis in a Tertiary Care Centre in India

Abstract

Malleshappa Pavan*,Ravi Ranganath,Anup P Chaudhari,Ashwinikumar Aiyangar,Keerti L Upadhayaya,Hemant J Mehta

Objective: Hypotension is quite common in any dialysis unit and despite significant improvements of hemodialysis techniques in the recent years; the frequency of recurrent intradialytic hypotension episodes has remained nearly unchanged. Our study is aimed to define the pathogenesis of intradialytic hypotension and attempts to describe effective measures for the hypotension prone hemodialysis patients on an individual basis. Design: This is a prospective study of 100 hemodialysis patients observed over 12 months at the Lilavati Hospital and Research Centre, Mumbai, India. Subjects with more than two episodes/month of hypotension on dialysis were diagnosed as having IDH. Results: Intradialytic hypotension was found in 18% of subjects. Incorrectly assessed ideal body weight was found to be the commonest cause of intradialytic hypotension. Volume assessment and adjusting the ideal body weight was found to be central to the problem of preventing intradialytic hypotension. Conclusion: This study shows that intradialytic hypotension is a common phenomenon, even in a tertiary care centre. Preventive strategies should be developed in each unit to decrease the future risk for intradialytic hypotension in specific patients.