Hypotension in dialysis refers to the decrease of average arterial pressure by more than 30 mmHg during dialysis compared with that before dialysis, or systolic pressure less than 90 mmHg. It is one of the common complications of hemodialysis patients, with an incidence of 20% - 30%. Why does my blood pressure drop with dialysis?
1. Reduction of effective blood volume
Dialysis patients have a dry weight. Hypotension occurs when the amount of water removed during each dialysis is lower than this weight. Obviously, hypotension will occur if the total amount of water removed is too low (below the dry weight). In addition, hypotension can also occur when the speed of water removal is too fast. As the effective blood volume decreases, the blood becomes thicker and the protein concentration increases, the extracapillary fluid moves continuously into the capillary, which is a process of capillary refilling. If the ultrafiltration rate is greater than the capillary recharge rate, hypotension will occur.
2. Changes of plasma osmotic pressure
During dialysis, plasma osmotic pressure drops rapidly due to the removal of urea, creatinine and other solutes, and forms an osmotic pressure gradient with extravascular fluid, which drives water to move to interstitial or intracellular areas and reduces the effective blood volume, leading to blood loss.
3. Hypoproteinemia, anemia, diabetes mellitus, polycystic liver, ascites and low protein intake
4. The concentration of sodium in dialysate is too low and the temperature of dialysate is too high.
5. Take large doses of long-acting antihypertensive drugs before dialysis, and take large doses or fast antihypertensive drugs during dialysis.
6. Cardiac factors, such as pericarditis, myocardial infarction, arrhythmia and heart failure.
7. The biocompatibility of dialyzer membranes is poor and allergies occur. Or the effect of hypoxemia on cardiovascular function.
8. Eating too much and too fast during dialysis can dilate gastrointestinal blood vessels and divert blood.
9. Others, such as sepsis, hemorrhage (such as hemodialysis pipeline hemorrhage, visceral hemorrhage), hemolysis and pericardial hemorrhage.
Why does my blood pressure drop with dialysis? Now you have a clear mind. Besides low blood pressure, you may have some other discomforts. That is why many kidney failure patients stop dialysis. If you would like to try some alternatives to maintain your life. You can try Toxin-Removing Treatment, which can help reduce the side effects of dialysis, preserve or even promote renal function to reduce dialysis frequency. For more information on this treatment, please leave a message below or contact online doctor.
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