Key result
Recent advances in bioimpedance technology, biofeedback systems, and pharmacologic strategies offer new approaches to prevent and manage intradialytic hypotension during maintenance hemodialysis.
Advances in dry weight determination via bioimpedance, biofeedback systems, and targeted pharmacologic strategies offer promising approaches to mitigate intradialytic hypotension.
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Pharmacologic approaches to intradialytic hypotension in hemodialysis remain unproven; leaves open need for randomized trials.
Intradialytic hypotension continues to play a significant role in the morbidity and in some cases the mortality associated with maintenance hemodialysis. Greater precision in the determination of dry weight using bioimpedance technology and biofeedback systems designed to prevent rapid fluctuations in blood volume have recently been shown to decrease the frequency of this complication. Pharmacologic strategies designed to maintain peripheral vascular resistance in patients with insufficient release of endogenous vasoconstrictors continue to be explored. The sudden development of intradialytic hypotension may respond to specific antagonists to hypotensive mediators.
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Palmer et al. (2008) conducted a review in Intradialytic hypotension. Prevention and management strategies (bioimpedance, biofeedback, pharmacologic agents) was evaluated. Recent advances in bioimpedance technology, biofeedback systems, and pharmacologic strategies offer new approaches to prevent and manage intradialytic hypotension during maintenance hemodialysis.
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