Mechanisms, Clinical Implications, and Treatment of Intradialytic Hypotension
| Autor: | Patrick B. Reeves, Finnian R. Mc Causland |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Epidemiology Adverse outcomes medicine.medical_treatment 030232 urology & nephrology Reviews Guidelines as Topic 030204 cardiovascular system & hematology Critical Care and Intensive Care Medicine Plasma volume End stage renal disease 03 medical and health sciences 0302 clinical medicine Fluid therapy Renal Dialysis medicine Humans Intensive care medicine Transplantation business.industry Maintenance hemodialysis Blood pressure Nephrology Kidney Failure Chronic Hemodialysis Intradialytic hypotension Hypotension business |
| Zdroj: | Clinical journal of the American Society of Nephrology : CJASN. 13(8) |
| ISSN: | 1555-905X |
| Popis: | Individuals with ESKD requiring maintenance hemodialysis face a unique hemodynamic challenge, typically on a thrice-weekly basis. In an effort to achieve some degree of euvolemia, ultrafiltration goals often involve removal of the equivalent of an entire plasma volume. Maintenance of adequate end-organ perfusion in this setting is dependent on the institution of a variety of complex compensatory mechanisms. Unfortunately, secondary to a myriad of patient- and dialysis-related factors, this compensation often falls short and results in intradialytic hypotension. Physicians and patients have developed a greater appreciation for the breadth of adverse outcomes associated with intradialytic hypotension, including higher cardiovascular and all-cause mortality. In this review, we summarize the evidence for adverse outcomes associated with intradialytic hypotension, explore the underlying pathophysiology, and use this as a basis to introduce potential strategies for its prevention and treatment. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|