Examination of the effects of nursing interventions on intradialytic hypotension

Abstract

Objective: This study will contribute to the understanding and management of hemodialysis-related complications, increase hemodialysis nurses' awareness and skills related to intradialytic hypotension management, help establish evidence-based clinical practice, and help develop clinical guidelines for the management of hemodialysis-related complications. Materials and Methods: This descriptive study involved 57 patients whose blood pressures and interventions for intradialytic hypotension were recorded for six hemodialysis sessions, for a total of 342 follow-ups. Results: Intradialytic hypotension developed at significantly high rates in cases in which the first hemodialysis session was performed after a 2-day break and in cases of high target ultrafiltration and pump rate values. Intradialytic hypotension developed during 219 of the 342 follow-ups. The Trendelenburg position alone was used in 195 follow-ups (89%) in which intradialytic hypotension developed, and the Trendelenburg position and pump rate reduction were used in 24 follow-ups (11%). Pump rate reduction alone was used in 151 follow-ups (68.9%). Conclusion: Using the Trendelenburg position alone and reducing the pump rate along with using the Trendelenburg position significantly increased the blood pressure in cases of intradialytic hypotension. Excessive use of the Trendelenburg position and reduction of the pump rate by 20-60 mL/min compared with the onset rate of hemodialysis were more effective in increasing the blood pressure.