Abstract
Some patients undergoing hemodialysis have postprandial hypotension (PPH) only during hemodialysis. We investigated the factors related to the onset of PPH during hemodialysis in PPH (+) (n=7) and PPH (-) (n=11) hemodialysis patients. The age, etiology of the chronic renal failure, complications, duration of hemodialysis, cardiothoracic ratio, electrocardiographic findings, complete blood count and blood chemistry findings, blood sugar levels and body weight before and after hemodialysis of the PPH (+) and PPH (-) hemodialysis patients were unrelated to the development of PPH during hemodialysis. However, there were significant differences between changes in pulse rate after lunch and patient mobility in the PPH (+) and PPH (-) groups. Pulse rate increased after lunch in 6 cases, did not change in 4 cases and decreased in one case in the PPH (-) group, whereas there was no change in 3 cases and a decrease in 4 cases in the PPH (+) group. Regarding mobility, all patients with PPH (-) could move by themselves, but only 2 of the 7 PPH (+) patients could move under their own power. The remaining 5 PPH (+) patients needed wheel chairs and chair-persons to move about.
It has been reported that the cause of PPH is sympathetic nerve dysfunction, and that reflex sympathetic activity is suppressed during ultrafiltration. Thus, PPH may easily develop while on hemodialysis, and the decrease in reflex sympathetic activity caused by lack of exercise may be related to the onset of PPH during hemodialysis.
