Study of factors related to hypotension in hemodialysis patients.
The factors related to hypotension in hemodialysis patients were evaluated. The subjects consisted of 120 hemodialysis patients (61 males and 59 females), whose ages ranged between 28 and 82 years, and who had undergone hemodialysis treatment for a period ranging between 3 and 201 months. They were divided into three groups: Group A, 53 normotensive patients; Group B, 52 patients with hypotension during hemodialysis; and Group C, 15 patients with constant hypotension. The evaluated factors were age, sex, etiology of renal failure, hemodialysis term, ultrafiltered volume, responsiveness to vasopressor drugs, Cr, Na, Ht, TP, cardiothoracic ratio, presence or absence of heart disease, and microvibration pattern. Statistical analysis was performed using multivariate analysis (Quantification II and IV methods). The results of the Quantification IV method indicated that Groups A and B were similar but Group C was quite different from the other two groups. The results of the Quantification II method indicated that the most important factor which characterized the difference between Group A and Group C was the responsiveness to vasopressor drugs, and the most important factor in the difference between Group B and Group C was the microvibration pattern. Group B was characterized by abnormal microvibration patterns and Group C was characterized by a low responsiveness of the peripheral vessels to vasopressor drugs. We conclude that the hypotension during hemodialysis was caused predominantly by dysfunction of the autonomic nervous system, while the constant hypotension was caused predominantly by a deterioration of constriction of the peripheral vessels.
Furukawa
A
A
Department of Urology, Takamatsu Red Cross Hospital, Kagawa, Japan.
Miyamoto
T
T
Tamura
M
M
Kawanishi
Y
Y
Numata
A
A
Yuasa
M
M
Imagawa
A
A
Kagawa
S
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001341:Autonomic Nervous System / Q000503:physiopathology; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D014661:Vasoconstriction