Publication: Reducing the risk of intradialytic hypotension by altering the composition of the dialysate
Issued Date
2020-01-01
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ISSN
15424758
14927535
14927535
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2-s2.0-85085143584
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Mahidol University
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SCOPUS
Bibliographic Citation
Hemodialysis International. (2020)
Suggested Citation
Kornchanok Vareesangthip, Andrew Davenport Reducing the risk of intradialytic hypotension by altering the composition of the dialysate. Hemodialysis International. (2020). doi:10.1111/hdi.12840 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/56313
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Title
Reducing the risk of intradialytic hypotension by altering the composition of the dialysate
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Abstract
© 2020 International Society for Hemodialysis Hypotension is the most common complication of outpatient hemodialysis sessions, with a reported prevalence of 4% to 31%, depending on which definition has been used and whether patients are symptomatic and nursing interventions were required. Dialysis centers which mix the dialysate in the dialysis machine have the opportunity to individualize the composition of the dialysate for patients. This permits a choice of dialysate sodium, potassium, calcium, magnesium, bicarbonate, acetate, and citrate concentrations and temperature. Studies have reported a higher intradialytic systolic blood pressure and fewer episodes of intradialytic hypotension when using a higher dialysate sodium, calcium, magnesium concentrations and lower temperature, but no clinical advantage for changing the potassium, bicarbonate, or citrate for acetate concentrations. The introduction of newer technology allowing real time measurements of plasma electrolyte concentrations will potentially allow changing the dialysate composition to reduce the risk of intradialytic hypotension without increasing the risk of positive electrolyte balances.
