Symptomatic hypotension during hemodialysis

Abstract

Symptoms during treatment with extracorporeal hemodialysis are an unpleasant fact of life maintained by the artificial kidney. During hemodialysis, a common clinical pattern is dizziness, malaise, nausea, and cramps accompanied by a fall in blood pressure, requiring some form of therapeutic intervention by the nurse or technical team. Such symptomatic hypotension occurs in approximately 25% of hemodialysis treatments. For some patients, symptomatic hypotension recurs frequently enough to make maintenance dialysis a nightmare. This review is an effort to fit into some kind of reasonable pathophysiologic schema the large body of information on symptomatic hypotension.