Research and Reviews: A Journal of Health Professions Review Article
A Study on the Incidence, Prevalence, and Causative Factors Associated with Intradialytic Hypotension During Maintenance Hemodialysis
Abstract
In Maintenance Hemodialysis (MHD), Intradialytic Hypotension (IDH) is a significant issue, occurring in around 15–30% of dialysis sessions and greatly affecting patient well-being and health outcomes. This study followed a group of 50 MHD patients for six months to investigate the frequency, prevalence, and causes of IDH. The findings revealed that having a low serum albumin level (<3.5 g/dL) was the most reliable indicator of IDH (OR: 4.1, 95% CI: 2.3–7.2, p
Keywords
References (35)
- Davenport A. Why is Intradialytic Hypotension the Commonest Complication of Outpatient Dialysis Treatments? Kidney International Reports. 2023;8(3):405-418. doi:10.1016/j.ekir.2022.10.031
- Kanbay M, Ertuglu LA, Afsar B, Ozdogan E, Siriopol D, Covic A, et al. An update review of intradialytic hypotension: concept, risk factors, clinical implications and management. Clinical Kidney Journal. 2020;13(6):981-993. doi:10.1093/ckj/sfaa078
- K/DOQI Workgroup (2005). K/DOQI clinical practice guidelines for cardiovascular disease in dialysis patients. American journal of kidney diseases : the official journal of the National Kidney Foundation, 45(4 Suppl 3), S1–S153. https://pubmed.ncbi.nlm.nih.gov/15806502/
- Mao Y, Xu L, Xu J, Tang Y, Liu T. Application Value of Limb Ischemic Preconditioning in Preventing Intradialytic Hypotension during Maintenance Hemodialysis. Kidney and Blood Pressure Research. 2023;48(1):535-544. doi:10.1159/000531855
- Dheenan S, Henrich WL. Preventing dialysis hypotension: A comparison of usual protective maneuvers. Kidney International. 2001;59(3):1175-1181. doi:10.1046/j.1523-1755.2001.0590031175.x
- Hamrahian SM, Vilayet S, Herberth J, Fülöp T. Prevention of Intradialytic Hypotension in Hemodialysis Patients: Current Challenges and Future Prospects. International Journal of Nephrology and Renovascular Disease. 2023;Volume16:173-181. doi:10.2147/ijnrd.s245621
- Wu Y, Lu J, Wang T, Zhu X, Xue J, You L. Association of frequent intradialytic hypotension with the clinical outcomes of patients on hemodialysis: a prospective cohort study. Renal Failure. 2024;46(1). doi:10.1080/0886022x.2023.2296612
- Yu J, Liu Z, Shen B, Teng J, Zou J, Ding X. Intradialytic Hypotension as an Independent Risk Factor for Long-Term Mortality in Maintaining Hemodialysis Patients: A 5-Year Follow-Up Cohort Study. Blood Purification. 2018;45(4):320-326. doi:10.1159/000486231
- Van Buren PN, Inrig JK. Special situations: Intradialytic hypertension/chronic hypertension and intradialytic hypotension. Seminars in Dialysis. 2017;30(6):545-552. doi:10.1111/sdi.12631
- Flythe JE, Xue H, Lynch KE, Curhan GC, Brunelli SM. Association of Mortality Risk with Various Definitions of Intradialytic Hypotension. Journal of the American Society of Nephrology. 2015;26(3):724-734. doi:10.1681/asn.2014020222
- Sands JJ, Usvyat LA, Sullivan T, Segal JH, Zabetakis P, Kotanko P, et al. Intradialytic hypotension: Frequency, sources of variation and correlation with clinical outcome. Hemodialysis International. 2014;18(2):415-422. doi:10.1111/hdi.12138
- Kuipers J, Verboom LM, Ipema KJR, Paans W, Krijnen WP, Gaillard CAJM, et al. The Prevalence of Intradialytic Hypotension in Patients on Conventional Hemodialysis: A Systematic Review with Meta-Analysis. American Journal of Nephrology. 2019;49(6):497-506. doi:10.1159/000500877
- Steinwandel U, Gibson N, Towell‐Barnard M, Parsons R, Rippey JJ, Rosman J. Measuring the prevalence of intradialytic hypotension in a satellite dialysis clinic: Are we too complacent? Journal of Clinical Nursing. 2018;27(7-8). doi:10.1111/jocn.14309
- HAJAL J, JOUBRAN N, SLEILATY G, CHACRA D, SALIBA Y, ASSAAD S, et al. Intradialytic Hypotension: Beyond Hemodynamics. Physiological Research. 2019:793-805. doi:10.33549/physiolres.934080
- Halle M, Hilaire D, Francois K, Denis T, Hermine F, Gloria A. Intradialytic hypotension and associated factors among patients on maintenance hemodialysis: A single-center study in cameroon. Saudi Journal of Kidney Diseases and Transplantation. 2020;31(1):215. doi:10.4103/1319-2442.279944
- Thongdee C, Phinyo P, Patumanond J, Satirapoj B, Spilles N, Laonapaporn B, et al. Ultrafiltration rates and intradialytic hypotension: A case–control sampling of pooled haemodialysis data. Journal of Renal Care. 2020;47(1):34-42. doi:10.1111/jorc.12340
- Levin NW, de Abreu MHFG, Borges LE, Tavares Filho HA, Sarwar R, Gupta S, et al. Hemodynamic response to fluid removal during hemodialysis: categorization of causes of intradialytic hypotension. Nephrology Dialysis Transplantation. 2018;33(9):1643-1649. doi:10.1093/ndt/gfy048
- Chao CT, Huang JW, Yen CJ. Intradialytic Hypotension and Cardiac Remodeling: A Vicious Cycle. BioMed Research International. 2015;2015:1-7. doi:10.1155/2015/724147
- Wu Y, Lu J, Wang T, Zhu X, Xue J, You L. Association of frequent intradialytic hypotension with the clinical outcomes of patients on hemodialysis: a prospective cohort study. Renal Failure. 2024;46(1). doi:10.1080/0886022x.2023.2296612
- Mahmood N, Hassan MMU, Mahmood F, Bari S. Hypotension During Haemodialysis: Aetiology, Risk Factors and Outcome. Anwer Khan Modern Medical College Journal. 2017;8(2):89-93. doi:10.3329/akmmcj.v8i2.33660
- Chou JA, Streja E, Nguyen DV, Rhee CM, Obi Y, Inrig JK, et al. Intradialytic hypotension, blood pressure changes and mortality risk in incident hemodialysis patients. Nephrology Dialysis Transplantation. 2017;33(1):149-159. doi:10.1093/ndt/gfx037
- SHIN JI, PARK SJ, KIM JH. Could intradialytic hypotension be due to low baseline magnesium levels or inflammation in hemodialysis patients? Hemodialysis International. 2011;15(2):301-302. doi:10.1111/j.1542-4758.2011.00534.x
- Dasgupta I, Thomas GN, Clarke J, Sitch A, Martin J, Bieber B, et al. Associations between Hemodialysis Facility Practices to Manage Fluid Volume and Intradialytic Hypotension and Patient Outcomes. Clinical Journal of the American Society of Nephrology. 2019;14(3):385-393. doi:10.2215/cjn.08240718
- Jefferies HJ, Burton JO, McIntyre CW. Individualised Dialysate Temperature Improves Intradialytic Haemodynamics and Abrogates Haemodialysis-Induced Myocardial Stunning, without Compromising Tolerability. Blood Purification. 2011;32(1):63-68. doi:10.1159/000324199
- Basile C, Lomonte C, Vernaglione L, Casucci F, Antonelli M, Losurdo N. The relationship between the flow of arteriovenous fistula and cardiac output in haemodialysis patients. Nephrology Dialysis Transplantation. 2007;23(1):282-287. doi:10.1093/ndt/gfm549
- Peyronel F, Parenti E, Fenaroli P, Benigno GD, Rossi GM, Maggiore U, et al. Integrated strategies to prevent intradialytic hypotension: research protocol of the DialHypot study, a prospective randomised clinical trial in hypotension-prone haemodialysis patients. BMJ Open. 2020;10(7):e036893. doi:10.1136/bmjopen-2020-036893
- Chazot C, Vo-Van C, Zaoui E, Vanel T, Hurot JM, Lorriaux C, et al. Fluid overload correction and cardiac history influence brain natriuretic peptide evolution in incident haemodialysis patients. Nephrology Dialysis Transplantation. 2011;26(8):2630-2634. doi:10.1093/ndt/gfq804
- Agarwal R, Light RP. Chronobiology of Arterial Hypertension in Hemodialysis Patients: Implications for Home Blood Pressure Monitoring. American Journal of Kidney Diseases. 2009;54(4):693-701. doi:10.1053/j.ajkd.2009.03.018
- Harshman LA, Alexander SR, Brophy PD. Intradialytic Hypotension: Potential Causes and Mediating Factors. Pediatr Nephrol 2024;39(3):678-90. https://www.researchgate.net/publication/319010931_Intradialytic_Hypotension_Potential_Causes_and_Mediating_Factors?_tp=eyJjb250ZXh0Ijp7InBhZ2UiOiJzY2llbnRpZmljQ29udHJpYnV0aW9ucyIsInByZXZpb3VzUGFnZSI6bnVsbCwic3ViUGFnZSI6bnVsbH19
- Petrović D. Intradialytic hypotension: Clinical consequences and basic prevention principals. Med Rev 2015;16(2):87-96.
- Bradshaw W. Intradialytic hypotension: A literature review. Nephrol Nurs J 2024;51(2):163-72. https://www.semanticscholar.org/paper/Intradialytic-hypotension-%3A-a-literature-review-and-Bradshaw-Bradshaw/2d5c71a9a60f5b692174bb3975cb6ba67ebf8198
- Mamadou, B. , Kane, Y. , Faye, M. , Dieng, A. , Bacary, B. , Keita, N. , Ndiaye, B. , Ndongo, M. , Abou, S. , Faye, M. , Lemrabott, A. and Fary, K. (2022) Intra-Dialytique Hypotension: Prevalence and Associated Factors in 2 Haemodialysis Centres in Senegal. Open Journal of Nephrology, 12, 361-368. doi: 4236/ojneph.2022.124036
- Halle M, Hilaire D, Francois K, Denis T, Hermine F, Gloria A. Intradialytic hypotension and associated factors among patients on maintenance hemodialysis: A single-center study in cameroon. Saudi Journal of Kidney Diseases and Transplantation. 2020;31(1):215. doi:10.4103/1319-2442.279944
- Kuipers J, Verboom LM, Ipema KJR, Paans W, Krijnen WP, Gaillard CAJM, et al. The Prevalence of Intradialytic Hypotension in Patients on Conventional Hemodialysis: A Systematic Review with Meta-Analysis. American Journal of Nephrology. 2019;49(6):497-506. doi:10.1159/000500877
- Steinwandel U, Gibson N, Towell‐Barnard M, Parsons R, Rippey JJ, Rosman J. Measuring the prevalence of intradialytic hypotension in a satellite dialysis clinic: Are we too complacent? Journal of Clinical Nursing. 2018;27(7-8). doi:10.1111/jocn.14309