Treatment to minimize intradialytic hypotension

Treatment to minimize intradialytic hypotension

What are some of the treatments used to help minimize intradialytic hypotension?

The incidence of hypotension can be minimized by assessing dry weight on a regular basis and counseling the patient on avoiding large fluid gains between dialysis treatments, using a combination of a fluid-restricted and low-salt diet.

Additional measures that may be beneficial include increasing the dialysis treatment time to decrease the hourly ultrafiltration rate, decreasing the dialysate temperature by 0.5°C to 2.0°C, avoiding intradialytic food ingestion, and using midodrine (an alpha-adrenergic agonist) in patients who do not have active cardiac ischemia.

Midodrine is ineffective if the patient is prescribed alpha-adrenergic blockers.

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