Locatelli et al identified risk factors for hypotension in a diabetic during hemodialysis. These can help to identify interventions to mitigate this complication. The authors are from A. Manzoni Hospital in Lecco, Italy.


Complications of intradialytic hypotension:

(1) inability to achieve dry weight targets

(2) worse blood pressure control


Risk factors for hypotension during hemodialysis:

(1) diabetic autonomic neuropathy

(2) impaired left ventricular compliance

(3) overhydration during the interval between dialysis sessions

(4) presence of vascular damage

(5) high ultrafiltration rate during the dialysis session

(6) aggressive antihypertensive therapy prior to a dialysis session


Interventions to reduce hypotensions:

(1) reduce or discontinue antihypertensive therapy prior to a dialysis session

(2) schedule a longer dialysis session to allow for a lower ultrafiltration rate


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