[Intradialysis hypotension: causes and sequelae].
OBJECTIVE
To study causes and sequelae of intradialysis hypotension (IH) in patients with terminal renal failure (TRF).


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.


CONCLUSIONS
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).
Milovanova
L Iu
LIu
Nikolaev
A Iu
AIu
Safonov
V V
VV
Milovanov
Iu S
IuS
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009123:Muscle Hypotonia / Q000209:etiology* / Q000401:mortality; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D016019:Survival Analysis