Low blood pressure is a common complication in kidney failure patients on maintenance dialysis, accounting for approximately 10% cases. This can result in cold sweats, pale, vomiting, blackouts, muscle cramps, convulsions, transient unconsciousness and arrhythmia. Correcting low blood pressure properly is of great importance in lowering life risks as well as prolonging life expectancy. The following is more details related to causes of low blood pressure during dialysis.
Blood pressure during dialysis can be classified into episode hypotension (EH) and sustained hypotension (SH). Of the two, EH is defined as systolic pressure decline for 30mmHg or mean arterial pressure (MAP) <100mg/Hg/ In comparison, MAP typically refers to systolic pressure within 100mmHg among patients on dialysis for years.
Causes of low blood pressure during dialysis:
1. Excess dehydration:
Dry body weight, referring to the lowest acceptable body weight where neither water retention nor water shortage. Excess dehydration during dialysis can cause body weight to be lower than the dry body weight, thus decreasing effective blood volume and resulting in low blood pressure.
2. Fast speed of eliminating water
The speed of eliminating water should be balanced during dialysis. If the speed is too fast, blood fluid will run to extracoreal blood circuit rapidly, thus decreasing internal circulation volume and causing hypotension.
3. Factors related to dislysate compositions and dislysate temperature:
(1) Dislysate compositions
One function of dialysis is to balance serum sodium level. Usually, dislysate sodium concentration should be lower than serum. Then due to concentration difference, sodium can run from the human body to the dislysate. However, if dislysate sodium level is too low, blood osmotic pressure can decrease, thus increasing cardiovascular instability and leading to low blood pressure.
(2) Dislysate temperature
Dislysate with high temperature can cause strenuous diastole. As a result, large amount of blood fluid is accumulated around venous blood vessels, thus reducing effective circulatory blood volume and inducing low blood pressure. Low temperature dislysate, instead, can decrease risks of low blood pressure. Medical researches indicate, for per 1.1℃ increase in dislysate temperature, incidence of blood pressure can increase for 3 times.
As we can conclude from the above, several factors coexist to increase risks of low blood pressure during dialysis. There are many other complications patients should try to avoid.
It is suggested for kidney dialysis patients to seek for personalized instruction. You may also communicate with our online experts directly for detailed nursing and treatment suggestions. Hope our endeavor can be of help for you!
Shijiazhuang Kidney Disease Hospital
Shijiazhuang Kidney Disease Hospital is located in Shijiazhuang city, capital of Hebei Province, which is adjacent to the capital of China, Beijing. It was founded in 1986 and his name has become more widely known in recent decades.....Read More
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