Education, Science, Technology, Innovation and Life
Open Access
Sign In
  1. Home
  2. Journals
  3. MEDS Clinical Medicine
  4. Vol 4, Issue 1, 2023

Personalized prevention and treatment strategies for hypotension patients during maintenance hemodialysis

Download as PDF

DOI: 10.23977/medsc.2023.040110 | Downloads: 35 | Views: 735

Author(s)

Yanruo Lu 1, Xiaogang Du 1

Affiliation(s)

1 Department of Nephrology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China

Corresponding Author

Xiaogang Du

ABSTRACT

Hemodialysis (HD) is the most common renal replacement therapy for patients with end-stage renal disease. Intradialytic hypotension (IDH) is a serious complication during dialysis. It is mainly related to hypovolemia, resulting in premature interruption of dialysis, and insufficient clearance of fluid and solute, which eventually causes a variety of adverse clinical outcomes such as decline in quality of life, inadequate dialysis, vascular access embolism, loss of residual renal function, cardiovascular events and death, seriously threatening the life and health of patients. Despite its clinical significance, the early prediction of IDH remains a challenge. In recent years, the discovery of some new biomarkers and the use of volume assessment devices, hemodialysis equipment, biofeedback systems, new drugs and artificial intelligence early warning models have provided great help in the early identification and treatment of IDH. In view of the clinical heterogeneity of blood pressure changes in hemodialysis patients, it has become an inevitable trend to shift from standardized management to personalized nursing. This article mainly reviews the best strategies for personalized prevention and treatment of IDH.

KEYWORDS

Hemodialysis; Hypotension; Prevention and treatment; Biomarkers; Dialysis equipment; Biofeedback system; Artificial intelligence

CITE THIS PAPER

Yanruo Lu, Xiaogang Du, Personalized prevention and treatment strategies for hypotension patients during maintenance hemodialysis. MEDS Clinical Medicine (2023) Vol. 4: 59-64. DOI: http://dx.doi.org/10.23977/medsc.2023.040110.

REFERENCES

[1] Van Der Sande F M, Van De Wal-Visscher E R, Stuard S, et al. Using Bioimpedance Spectroscopy to Assess Volume Status in Dialysis Patients [J]. Blood Purification, 2020, 49(1-2): 178-184.
[2] Khanin Y, Hirsch J S, Stalbow D, et al. Intradialytic Hypotension in Critically Ill Patients on Hemodialysis With A-Line versus B-Line Pattern on Lung Ultrasonography [J]. Kidney International Reports, 2021, 6(7): 1969-1972.
[3] Loutradis C, Sarafidis P A, Ekart R, et al. Ambulatory blood pressure changes with lung ultrasound-guided dry-weight reduction in hypertensive hemodialysis patients: 12-month results of a randomized controlled trial [J]. Journal of Hypertension, 2021, 39(7): 1444-1452.
[4] Causland F R M, Ravi K S, Curtis K A, et al. A randomized controlled trial of two dialysate sodium concentrations in hospitalized hemodialysis patients [J]. Nephrology, Dialysis, Transplantation: Official Publication of the European Dialysis and Transplant Association - European Renal Association, 2022, 37(7): 1340-1347.
[5] Álvarez Nadal M, Martín Capón I, Viera Ramírez E R, et al. Absolute blood volume variations during hemodialysis: Does dialysate temperature play a role? [J]. Seminars In Dialysis, 2021, 34(4): 309-314. 
[6] Thongdee C, Phinyo P, Patumanond J, et al. Ultrafiltration rates and intradialytic hypotension: A case-control sampling of pooled haemodialysis data [J]. Journal of Renal Care, 2021, 47(1): 34-42.
[7] Canaud B, Blankestijn P J, Grooteman M P C, et al. Why and how high volume hemodiafiltration may reduce cardiovascular mortality in stage 5 chronic kidney disease dialysis patients? A comprehensive literature review on mechanisms involved [J]. Seminars In Dialysis, 2022, 35(2): 117-128.
[8] Macedo E, Karl B, Lee E, et al. A randomized trial of albumin infusion to prevent intradialytic hypotension in hospitalized hypoalbuminemic patients [J]. Critical Care (London, England), 2021, 25(1): 18.
[9] Tang X, Chen L, Chen W, et al. Effects of diuretics on intradialytic hypotension in maintenance dialysis patients: a systematic review and meta-analysis [J]. International Urology and Nephrology, 2021, 53(9): 1911-1921.
[10] Nadal M Á, Viera Ramírez E R, García Vallejo M, et al. Effect of Beta-Blocker Cardioselectivity on Vascular Refilling in Hemodialysis Patients [J]. Cardiorenal Medicine, 2021, 11(5-6): 237-242.
[11] Razeghi E, Dashti-Khavidaki S, Nassiri S, et al. A randomized crossover clinical trial of sertraline for intradialytic hypotension [J]. Iranian Journal of Kidney Diseases, 2015, 9(4): 323-330.
[12] Seo Y, Jeung S, Kang S-M, et al. Use of fludrocortisone for intradialytic hypotension [J]. Kidney Research and Clinical Practice, 2018, 37(1): 85-88.
[13] Alhawari H H, Alshelleh S, Alhawari H H, et al. Effect of Hydrocortisone on Intradialytic Hypotension: A Preliminary Investigational Study [J]. BioMed Research International, 2020, 2020: 4987547.
[14] Ibarra-Sifuentes H R, Del Cueto-Aguilera Á, Gallegos-Arguijo D A, et al. Levocarnitine Decreases Intradialytic Hypotension Episodes: A Randomized Controlled Trial [J]. Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society For Apheresis, the Japanese Society For Apheresis, the Japanese Society For Dialysis Therapy, 2017, 21(5): 459-464.
[15] Imai E, Fujii M, Kohno Y, et al. Adenosine A1 receptor antagonist improves intradialytic hypotension [J]. Kidney International, 2006, 69(5): 877-883.
[16] Rao N S, Chandra A, Saran S, et al. Predialytic versus Intradialytic Nutrition: A Study to Assess Effects on Intradialytic Blood Pressure, Dialysis Adequacy, and Urea Removal [J]. Blood Purif, 2021, 50(6): 823-828.
[17] Yu J, Chen X, Li Y, et al. Pro-inflammatory cytokines as potential predictors for intradialytic hypotension [J]. Renal Failure, 2021, 43(1): 198-205.
[18] Assayag M, Levy D, Seris P, et al. Relative Change of Protidemia Level Predicts Intradialytic Hypotension [J]. Journal of the American Heart Association, 2020, 9(1): e014264.
[19] Rotondi S, Tartaglione L, De Martini N, et al. Oxygen extraction ratio to identify patients at increased risk of intradialytic hypotension [J]. Scientific Reports, 2021, 11(1): 4801.
[20] Mizuiri S, Nishizawa Y, Doi T, et al. Coronary artery calcification is a risk factor for intradialytic hypotension in patients undergoing hemodialysis [J]. Hemodialysis International. International Symposium On Home Hemodialysis, 2022, 26(3): 335-344.
[21] Lai C-J, Shih C-C, Huang H-H, et al. Detecting Volemic, Cardiac, and Autonomic Responses from Hypervolemia to Normovolemia Non-Invasive ClearSight Hemodynamic Monitoring During Hemodialysis: An Observational Investigation [J]. Frontiers In Physiology, 2022, 13: 775631.
[22] Mantri Y, Dorobek T R, Tsujimoto J, et al. Monitoring peripheral hemodynamic response to changes in blood pressure via photoacoustic imaging [J]. Photoacoustics, 2022, 26: 100345.
[23] Alvis B D, Polcz M, Miles M, et al. Non-invasive venous waveform analysis (NIVA) for volume assessment in patients undergoing hemodialysis: an observational study [J]. BMC Nephrology, 2020, 21(1): 194.
[24] Reach P, Touzot M, Lombardi Y, et al. Electrochemical skin conductance by Sudoscan®: a new tool to predict intradialytic hypotension [J]. Nephrology, Dialysis, Transplantation: Official Publication of the European Dialysis and Transplant Association - European Renal Association, 2021, 36(8): 1511-1518.
[25] Coppolino G, Carnevali A, Gatti V, et al. OCT angiography metrics predict intradialytic hypotension episodes in chronic hemodialysis patients: a pilot, prospective study [J]. Scientific Reports, 2021, 11(1): 7202.
[26] Ertuglu L A, Demiray A, Basile C, et al. Sodium and ultrafiltration profiling in hemodialysis: A long-forgotten issue revisited [J]. Hemodialysis International. International Symposium On Home Hemodialysis, 2021, 25(4): 433-446.
[27] Lee H, Yun D, Yoo J, et al. Deep Learning Model for Real-Time Prediction of Intradialytic Hypotension [J]. Clinical Journal of the American Society of Nephrology: CJASN, 2021, 16(3): 396-406.

Subscription
E-Mail Alert
Most popular papers
Call for Special Issue
Publication Ethics & OA Statement
Plagiarism Policy
Contact Us
Downloads: 4537
Visits: 195626

Sponsors, Associates, and Links

All published work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright © 2016 - 2031 Clausius Scientific Press Inc. All Rights Reserved.