INTRADIALYTIC COMPLICATIONS IN PATIENTS OF END-STAGE RENAL DISEASE ON MAINTENANCE HEMODIALYSIS
DOI:
https://doi.org/10.22159/ijcpr.2024v16i5.5080Keywords:
End-stage renal disease, Hemodialysis, Intradialytic complications, Hypertension, Fluid management, Vascular accessAbstract
Objective: End-stage renal disease (ESRD) patients on maintenance hemodialysis are at high risk for intradialytic complications, which can significantly impact morbidity and mortality. Understanding the prevalence and predictors of these complications is essential for improving patient care and outcomes.
Methods: This observational study included 104 ESRD patients undergoing maintenance hemodialysis at a tertiary care center. Data were collected on demographics, comorbidities, dialysis parameters, and vascular access type. Statistical analyses were conducted using SPSS to evaluate associations between patient characteristics and the occurrence of intradialytic complications.
Results: Our study analyzed 104 hemodialysis patients, revealing a high incidence of hypotensive episodes (59.0%) and associated symptoms like tiredness and muscle cramps. Vascular access was predominantly through arteriovenous fistulae (87.0%). Compliance with Kidney Disease Outcomes Quality Initiative (KDOQI) and European Best Practice Guidelines (EBPG) was low, at 11.1% and 6.8%, respectively, underscoring the need for improved management strategies to mitigate intradialytic complications.
Conclusion: Intradialytic complications are prevalent among ESRD patients on maintenance hemodialysis, with cardiovascular comorbidities contributing significantly to their risk. Effective management requires careful fluid and medication management to mitigate these risks and improve patient outcomes.
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References
Flythe JE, Kimmel SE, Brunelli SM. Rapid fluid removal during dialysis is associated with cardiovascular morbidity and mortality. Kidney Int. 2011;79(2):250-7. doi: 10.1038/ki.2010.383, PMID 20927040.
Assimon MM, Flythe JE. Intradialytic blood pressure abnormalities: the highs the lows and all that lies between. Am J Nephrol. 2015;42(5):337-50. doi: 10.1159/000441982, PMID 26584275.
Sands JJ, Usvyat LA, Sullivan T, Segal JH, Zabetakis P, Kotanko P. Intradialytic hypotension: frequency sources of variation and correlation with clinical outcome. Hemodial Int. 2014;18(2):415-22. doi: 10.1111/hdi.12138, PMID 24467830.
Weisbord SD, Fried LF, Arnold RM, Fine MJ, Levenson DJ, Peterson RA. Prevalence severity and importance of physical and emotional symptoms in chronic hemodialysis patients. J Am Soc Nephrol. 2005;16(8):2487-94. doi: 10.1681/ASN.2005020157, PMID 15975996.
Palmer SC, Navaneethan SD, Craig JC, Johnson DW, Tonelli M, Garg AX. Hemoconcentration and poor outcomes in hemodialysis patients. JASN. 2013;24(3):505-12.
Ronco C, Bellomo R. Understanding cardiac biomarkers and kidney injury during hemodialysis: are we on the cusp of a new understanding of cardiovascular complications. Nephrol Dial Transplant. 2015;30(9):1564-71.
Gayer G. Abdominal ectopic pregnancy. N Engl J Med. 2012;367(24):2334. doi: 10.1056/NEJMicm1111814, PMID 23234516.
Agarwal R, Sinha AD. Cardiovascular protection with antihypertensive drugs in dialysis patients: systematic review and meta-analysis. Hypertension. 2009;53(5):860-6. doi: 10.1161/hypertensionaha.108.128116, PMID 19273737.
Daugirdas JT. Pathophysiology of dialysis hypotension: an update. Am J Kidney Dis. 2001;38(4)Suppl 4:S11-7. doi: 10.1053/ajkd.2001.28090, PMID 11602456.
Davenport A. Review article: low blood pressure during hemodialysis does not seem to affect survival. Kidney Int. 2009;76(9):930-6.
Foley RN, Gilbertson DT, Murray T, Collins AJ. Long interdialytic interval and mortality among patients receiving hemodialysis. N Engl J Med. 2011;365(12):1099-107. doi: 10.1056/NEJMoa1103313, PMID 21992122.
K/DOQI Workgroup. K/DOQI clinical practice guidelines for cardiovascular disease in dialysis patients. Am J Kidney Dis. 2005 Apr;45(4 Suppl 3):S1-153. PMID 15806502.
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Copyright (c) 2024 ANKUR GOEL, HARPREET GREWAL, ARUN DUA
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