电邮这篇文章 Intradialysis hypotension: causes and sequelae
- 作者: Milovanova LY.1, Nikolaev AY.1, Safonov VV1, Milovanov Y.S1
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隶属关系:
- ММА им. И. М. Сеченова
- 期: 卷 78, 编号 6 (2003)
- 页面: 50-53
- 栏目: Editorial
- URL: https://journals.rcsi.science/0040-3660/article/view/29387
- ID: 29387
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Aim. To study causes and sequelae of intradialysis hypotension (IH) in patients with terminal renal
failure (TRF).
Material and methods. Forty one patients with TRF on chronic hemodialysis (CH) were divided into
two groups. The study group consisted of 24 patients with episodes of IH. Seventeen patients of the
control group had no IH. All the patients were examined with assessment of protein-energy deficiency
residual renal function, left-ventricular hypertrophy, diastolic function of the heart. Hemodialysis effectiveness
was estimated by Kt/V index. Survival of the patients was calculated according to Kaplan-Meier
method.
Results. In the study group IH episodes occurred in spite of low ultrafiltration velocity (8-10 ml/min).
Those patients of the study group who had IH associated with polyneuropathy and left-ventricular
hypertrophy had IH episodes more often and sharper falls of arterial pressure. Long-term IH decreased
survival significantly.
Conclusion. Repeated episodes of IH deteriorate effectiveness of hemodialysis because of acute coronary
syndrome, acute disorder of cerebral circulation, complications of deficient dialysis syndrome
(pericarditis, hyperkaliemia, pulmonary edema, congestive heart failure).
failure (TRF).
Material and methods. Forty one patients with TRF on chronic hemodialysis (CH) were divided into
two groups. The study group consisted of 24 patients with episodes of IH. Seventeen patients of the
control group had no IH. All the patients were examined with assessment of protein-energy deficiency
residual renal function, left-ventricular hypertrophy, diastolic function of the heart. Hemodialysis effectiveness
was estimated by Kt/V index. Survival of the patients was calculated according to Kaplan-Meier
method.
Results. In the study group IH episodes occurred in spite of low ultrafiltration velocity (8-10 ml/min).
Those patients of the study group who had IH associated with polyneuropathy and left-ventricular
hypertrophy had IH episodes more often and sharper falls of arterial pressure. Long-term IH decreased
survival significantly.
Conclusion. Repeated episodes of IH deteriorate effectiveness of hemodialysis because of acute coronary
syndrome, acute disorder of cerebral circulation, complications of deficient dialysis syndrome
(pericarditis, hyperkaliemia, pulmonary edema, congestive heart failure).
作者简介
L Milovanova
ММА им. И. М. СеченоваММА им. И. М. Сеченова
A Nikolaev
ММА им. И. М. СеченоваММА им. И. М. Сеченова
V Safonov
ММА им. И. М. СеченоваММА им. И. М. Сеченова
Yu Milovanov
ММА им. И. М. СеченоваММА им. И. М. Сеченова
参考
- Daudirdas J. T. Pathophysiology of dialysis hypotension: An update. Am. J. Kidney Dis. 2001; 38: SU-S17.
- Schreiber M. J. Clinical dilemmas in dialysis: Managing the hypotensive patient setting the stage. Ibid. SI-S10.
- Misra M., Vonesh E., Van Stone J. С. et al. Effect of cause and time of dropout on the residual GFR: A comparative analysis of the decline of GFR on dialysis. Kidney Int. 2001; 59: 754- 763.
- Leypoldt J. K., Cheung A. K., Steuer R. R. et al. Determination of circulating blood volume by continuously monitoring hematocrit during hemodialysis. J. Am. Soc. Nephrol. 1995- 6' 214-219.
- Foley R. N., Paifrey P. S., Kent G. M. et al. Long-term evolution of cardiomyopathy in dialysis patients. Kidney Int. 1998; 54: 1720-1725.
- Krepel H. P., Nette R. W., Akcahuseyin E. et al. Variability of relative blood volume during hemodialysis. Nephrol. Dial. Transplant. 2000; 15: 673-679.
- Foley R. N., Porfrey P. S., Harnett J. D. et al. The impact of anemia on cardiomyopathy, morbidity, and mortality in endstage renal disease. Am. J. Kidney Dis. 1996; 28: 53-61.
- Locatelli F., Marcelli D., Conte F. et al. Cardiovascular disease in chronic renal failure: the challenge continues. Nephrol. Dial. Transplant. 2000; I5(suppl. 5): 69-80.
- Madore F., Lowrie E. G., Brugnara C. et al. Anemia in hemodialysis patients: variables affecting this outcome predictor. J.Am. Soc. Nephrol. 1997; 8: 1921-1929.
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