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J Am Soc Nephrol 19: 8-11, 2008
© 2008 American Society of Nephrology
doi: 10.1681/ASN.2007091006
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Clinical Commentary

Recent Advances in the Prevention and Management of Intradialytic Hypotension

Biff F. Palmer* and William L. Henrich{dagger}

* Department of Internal Medicine, Division of Nephrology, University of Texas Southwestern Medical Center, Dallas, Texas; and {dagger} Department of Medicine, School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas

Correspondence: Dr. Biff F. Palmer, Department of Internal Medicine, Division of Nephrology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390. Phone: 214-648-7848; Fax: 214-648-2071; E-mail: Biff.Palmer{at}UTSouthwestern.edu

Intradialytic hypotension continues to play a significant role in the morbidity and in some cases the mortality associated with maintenance hemodialysis. Greater precision in the determination of dry weight using bioimpedance technology and biofeedback systems designed to prevent rapid fluctuations in blood volume have recently been shown to decrease the frequency of this complication. Pharmacologic strategies designed to maintain peripheral vascular resistance in patients with insufficient release of endogenous vasoconstrictors continue to be explored. The sudden development of intradialytic hypotension may respond to specific antagonists to hypotensive mediators.






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Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673