Abstract
Dialysis-induced hypotension interferes with adequate removal of fluid and sufficient correction of uremia, which might sometimes initiate a vicious cycle in the clinical status.This study was planned to determine the effectiveness for dialysis-induced hypotension of various modes of hemopurification.According to the analysis of the predialysis blood pressure in 374 patients on maintenance hemodialysis, 14.7% were hypertensive, 78.3% were normotensive and 7.0% were hypotensive.Dialysis-induced hypotension occurred equally at 31% in each of the three groups.The occurrence of hypotension during various modes of treatment was 30.9% in the case of conventional dialysis (C.HD), 18.9% in cold dialysate dialysis (cold HD), 17.6% in high-sodium dialysate (145mEq/l) dialysis (HS.HD), 16.7% in hemodiafiltration (HDF) and 15.7% in hemofiltration (HF). The cold HD significantly increased the systolic blood pressure to 127.8±19.6mmHg (mean±1SD), from 106.2±19.9mmHg at the time of C. HD, although it did not increase the diastolic pressure nor the heart rate. From the study of the core temperature, this increase in systolic blood pressure seemed to be due to increased resistance of the peripheral vessels.These results indicate that cold HD was not only effective for dialysis-induced hypotension as well as HS.HD, HF and HDF but also has the advantage of not requiring any special equipment.
