Key result
Postural changes from supine to semi-recumbent and sitting positions immediately after hemodialysis significantly decreased systolic blood pressure in patients with intradialytic hypotension, although changes did not significantly differ from patients without intradialytic hypotension.
Why the study?
Orthostatic hypotension is a risk factor for falls in chronic hemodialysis patients, prompting investigation of the hemodynamic response to orthostatic stress immediately after a dialysis session.
Does orthostatic stress immediately after a hemodialysis session cause greater hemodynamic instability in patients with intradialytic hypotension compared to those without?
Observational (n=21)
No
Does orthostatic stress immediately after a hemodialysis session cause greater hemodynamic instability in patients with intradialytic hypotension compared to those without?
Patients with intradialytic hypotension experience significant drops in systolic blood pressure upon postural changes immediately after hemodialysis, highlighting the need for careful monitoring to prevent post-dialytic falls.
Post-dialysis postural SBP drops warrant monitoring regardless of intradialytic hypotension history; leaves open differential orthostatic risk.
Orthostatic hypotension is a risk factor for falls among chronic hemodialysis (HD) patients. This study aimed to investigate the hemodynamic response to orthostatic stress immediately after an HD session. Twenty-one HD patients (mean age, 70.2 ± 8.1 years; HD duration, 7.5 ± 6.4 years) participated in this study. Each 5-min hemodynamic monitoring was performed in the supine, semi-recumbent, and sitting positions immediately after an HD session. Hemodynamic variables were measured using a noninvasive beat-to-beat monitoring device during the test. Patients were divided into an intradialytic hypotension (IDH) group and a non-IDH group according to the presence or absence of IDH on the day of the measurements, and intra- and intergroup comparisons were performed. In the IDH group, the nadir values of systolic blood pressure in the semi-recumbent and sitting positions were significantly lower than those in the supine position and the last systolic blood pressure in the semi-recumbent position. The nadir of stroke volume in the sitting position was significantly lower than that in the supine position. There were no statistically significant intergroup differences in the changes for any positions. These results suggest that patients with IDH require special attention when getting out of bed to prevent post-dialytic falls.
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Mochizuki et al. (2018) conducted an observational in Chronic hemodialysis (n=21). Intradialytic hypotension (IDH) vs. Non-IDH was evaluated on Changes in hemodynamic parameters (including systolic blood pressure) during postural changes immediately after hemodialysis. Postural changes from supine to semi-recumbent and sitting positions immediately after hemodialysis significantly decreased systolic blood pressure in patients with intradialytic hypotension, although changes did not significantly differ from patients without intradialytic hypotension.
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