Why is Intradialytic Hypotension the Commonest Complication of Outpatient Dialysis Treatments?

Davenport, Andrew

doi:10.1016/j.ekir.2022.10.031

Cited by 22 publications

(17 citation statements)

References 150 publications

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“…Intradialytic hypotension is the most common complication in HD, its frequency has shown a strong correlation with intradialytic weight gain, cardiac morbidity, and mortality. This is attributable to the hemodynamic stress that is caused by HD, which may cause myocardial ischemia [5,12].…”

Section: Intradialytic Hypotension (Idh)mentioning

confidence: 99%

Challenges and Outcomes of Chronic Dialysis in Children: A Narrative Review

Sager,

Alkaleb,

Alhariqi

et al. 2024

J. Pharm. Res. Int.

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Chronic dialysis is a life-saving treatment for children with end-stage renal disease (ESRD). However, it comes with difficult challenges, cardiovascular ones being the most significant and fatal. Chronic kidney disease-mineral bone disorder (CKD-MBD) is also a common complication of chronic dialysis, as it has significant effects on growth and cardiovascular health. Infections are also a significant problem for those on chronic dialysis. The cost of dialysis and the lifestyle of Children with CKD are also not optimal, as they have a significantly lower Health-related quality of life (HRQoL) than children with other chronic illnesses. Children on chronic dialysis face several difficult challenges, which differ between peritoneal dialysis (PD) and hemodialysis (HD). Most of these challenges are manageable or preventable. This review article will discuss some of the challenges that children and their families encounter during chronic dialysis strategies to manage these challenges and the outcomes of long-term kidney dialysis.

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Section: Intradialytic Hypotension (Idh)mentioning

confidence: 99%

Challenges and Outcomes of Chronic Dialysis in Children: A Narrative Review

Sager,

Alkaleb,

Alhariqi

et al. 2024

J. Pharm. Res. Int.

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show abstract

“…For example, many of the factors that exacerbate intradialytic hypotension, the most commonly reported and troublesome dialysis complication, can be attributed to an aging and damaged cardiovasular system. 1 Whereas hypertension was once the main concern of volume control, hypotension is now a significant risk factor and challenge when fluid needs to be removed. Fatigue, the symptom that hemodialysis patients would most wish to be rid of, 2 is undoubtedly exacerbated by the increased frailty of this population, as is prolonged postdialysis recovery time, itself associated with worse survival.…”

Section: A Changing Demographicmentioning

confidence: 99%

“… 10 As clinicians, we can influence fluid balance through the dialysis prescription, but changing how fluid is distributed in the body is far more challenging. Trials evaluating these methods as useful guides to fluid management, including relative blood volume monitoring, 1 bioimpedance, 11 and lung ultrasound have not been promising overall. 12 As such, these technologies should only be used in conjunction with a holistic clinical fluid assessment.…”

Section: The Role Of Technologiesmentioning

confidence: 99%

Volume Management in Hemodialysis—A Moving Target

Davies

2023

Kidney360

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“…Patient-related factors include advanced age, pregnancy, obesity, diabetes mellitus (DM), anemia, and hypertension. On the other hand, technical considerations include the presence of a block level at or above T5, administration of large doses of local anesthetics, and use of opioids during premedication ( 9 , 10 ).…”

Section: Introductionmentioning

confidence: 99%

Intrathecal Injection of Hyperbaric Bupivacaine Versus a Mixture of Hyperbaric and Isobaric Bupivacaine in Lower Abdominal Surgery: A Randomized Controlled Trial

Hassan,

Saleh,

Mohamed

et al. 2024

Anesth Pain Med

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Background: Bupivacaine hydrochloride is widely used as the primary drug for spinal anesthesia. Objectives: This research aimed to evaluate the intrathecal administration of both isobaric and hyperbaric bupivacaine (HB) in lower abdominal surgery. Methods: A randomized, controlled, double-blind trial was conducted on 50 patients classified as American Society of Anesthesiologists (ASA) class I to II, scheduled for lower abdominal surgery under spinal anesthesia. The patients were allocated randomly into two groups of similar size. Group A (control group) received 20 mg HB 0.5% intrathecally. Group B (case group) received 10 mg HB 0.5% and 10 mg isobaric bupivacaine (IB) 0.5%. Results: There was a significant decline in heart rate and mean arterial pressure in Group A compared to Group B (P < 0.05). Group A had a significantly greater sensory level at 10 and 20 minutes than Group B (P = 0.008 and 0.006, respectively). Group A had an earlier duration in reaching Bromage 3 and the first need for analgesia, compared to group B (P = 0.001 and 0.003, respectively). Conclusions: In lower abdominal surgery, the intrathecal administration of HB with IB increased hemodynamic stability and duration of both sensory and motor blockade but with slower recovery from anesthesia compared to HB alone.

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Why is Intradialytic Hypotension the Commonest Complication of Outpatient Dialysis Treatments?

Cited by 22 publications

References 150 publications

Challenges and Outcomes of Chronic Dialysis in Children: A Narrative Review

Challenges and Outcomes of Chronic Dialysis in Children: A Narrative Review

Volume Management in Hemodialysis—A Moving Target

Intrathecal Injection of Hyperbaric Bupivacaine Versus a Mixture of Hyperbaric and Isobaric Bupivacaine in Lower Abdominal Surgery: A Randomized Controlled Trial

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