Análisis de la tolerancia hemodinámica en pacientes en hemodiálisis medida por la hipotensión arterial

Abstract

Symptomatic hypotension is one of the most frequent acute complications in haemodialysis. The aim of our study is to evaluate the efficacy of the controlled administration of a hypertonic saline solution in preventing episodes of symptomatic arterial hypotension. This is a study comprising two phases of 15 sessions each, which included 15 patients, with ages ranging from 30 to 85. In phase A, the habitual procedures of the unit were followed and in phase B a 20% hypertonic saline solution was administered at the controlled rate of one bottle (10ml) every hour, in the initial and middle phases of the sessions, avoiding the last 30 or 60 minutes. A significant reduction was observed between phase A and phase B in the average number of episodes of intradialytic hypotension, in the degree of malaise, in intradialytic joint pain and in post-dialysis plasma Na+, as well as in the volume infusion. No significant differences in inter-dialysis thirst and weight gain were observed, or in post-dialysis pain. The results suggest that the administration of controlled hypertonic sodium chloride in the initial and middle phases of the session has clinical usefulness in patients with prior episodes of symptomatic hypotension during haemodialysis.