Intra-dialytic hypotension and blood volume and blood temperature monitoring.

Abstract

Intra-dialytic hypotension (IDH) is a common problem affecting haemodialysis patients. Its aetiology is complex and influenced by multiple patient and dialysis factors. IDH occurs when the normal cardiovascular response cannot compensate for volume loss associated with ultrafiltration, and is exacerbated by a myriad of factors including intra-dialytic fluid gains, cardiovascular disease, antihypertensive medications and the physiological demands placed on patients by conventional haemodialysis. The use of blood volume monitoring and blood temperature monitoring technologies is advocated as a tool to predict and therefore prevent episodes of IDH. We review the clinical utility of these technologies and summarize the current evidence of their effect on reducing the incidence of IDH in haemodialysis population. This review examines the roles of blood volume and temperature monitoring as means to prevent intra-dialytic hypotension. The authors form the view that these techniques are of limited usefulness in the general haemodialysis population. © 2011 Asian Pacific Society of Nephrology.