HYPOTENSION

BY KENJIE DOMINIQUE PULGO

WHAT IS
HYPOTENSION?
This occurs when blood pressure
values fall below the normal range.
This commonly happens in dialysis
patients due to a number of
factors.
 POSSIBLE
CAUSES
Excessive fluid removal
Low calcium and sodium in dialysate
Poor nutrition
Blood pressure medications
Weight gain
Anemia
 SIGNS AND SYMPTOMS
DIZZINESS NAUSEA/VOMITING MUSCLE CRAMPS

BELOW 90/60

LOW BLOOD
PRESSURE
PALLOR LOSS OF CONCIOUSNESS
 PATHOPHYSIOLOGY OF HYPOTENSION
NON MODIFIABLE MODIFIABLE FACTORS
FACTORS
LEGEND
1. Age 1. Lifestyle
Older patients Obese patients M/NM FACTORS
2. Gender 2. Medication
Female 3. Dialysis regimen
3. Health status
PATHOPHYSIOLOGY

Initiation of HD /
Thermal stress Osmotic shifts
ultrafiltration SIGNS/SYMPTOMS

Decline in blood
Vasodilation
volume

Decreased pressure exerted Intradialytic

on the walls of arteries Hypotension

Decrease in blood Decline in tissue

pressure perfusion

Pallor Muscle cramps Loss of conciousness Lightheadedness

 MANAGEMENT
FLUID MANAGEMENT
Adjusting the ultrafiltration
rate and temperature of the
dialysate during dialysis
sessions.

MEDICATIONS
Midodrine is used as a last
resort for severe cases. Give
PNSS bolus as ordered.
MANAGEMENT
POSITIONING
Allows for optimization of
blood flow and reduces
further risk

MONITORING
Continuous monitoring of
patient’s condition, as well as
further providing education
REFERENCES
https://www.youtube.com/watch?v=OBFUYssI4S8
https://www.verywellhealth.com/complications-at-hemodialysis-low-
blood-pressure-3954431
https://www.youtube.com/watch?v=fEGekEIKqaQ
https://www.dpcedcenter.org/news-events/news/low-blood-pressure-
intradialytic-hypotension/
https://www.sciencedirect.com/science/article/pii/S0085253815518553
https://homedialysis.org/home-dialysis-basics/machines-and-
supplies/dialysis-museum
https://homedialysis.org/news-and-research/news/living-well-with-home
treatments/articles/478-uk-home-dialyzor-named-longest-surviving-
dialysis-
patient#:~:text=Mahesh%20Mehta%20in%20the%20UK,at%2043%20year
20and%20counting.