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Review
. 2021 Mar;21(3):282.
doi: 10.3892/etm.2021.9713. Epub 2021 Jan 26.

Management of acute intradialytic cardiovascular complications: Updated overview (Review)

Delia Timofte  1 , Maria-Daniela Tanasescu  2   3 , Daniela Gabriela Balan  4 , Adrian Tulin  5   6 , Ovidiu Stiru  7   8 , Ileana Adela Vacaroiu  9   10 , Andrada Mihai  11   12 , Cristian Constantin Popa  13   14 , Cristina-Ileana Cosconel  15 , Mihaly Enyedi  5   16 , Daniela Miricescu  17 , Raluca Ioana Papacocea  18 , Dorin Ionescu  2   3
Affiliations
Review

Management of acute intradialytic cardiovascular complications: Updated overview (Review)

Delia Timofte et al. Exp Ther Med. 2021 Mar.

Abstract

An increasing number of patients require renal replacement therapy through dialysis and renal transplantation. Chronic kidney disease (CKD) affects a large percentage of the world's population and has evolved into a major public health concern. Diabetes mellitus, high blood pressure and a family history of kidney failure are all major risk factors for CKD. Patients in advanced stages of CKD have varying degrees of cardiovascular damage. Comorbidities of these patients, include, on the one hand, hypertension, hyperlipidemia, hyperglycemia, hyperuricemia and, on the other hand, the presence of mineral-bone disorders associated with CKD and chronic inflammation, which contribute to cardiovascular involvement. Acute complications occur quite frequently during dialysis. Among these, the most important are cardiovascular complications, which influence the morbidity and mortality rates of this group of patients. Chronic hemodialysis patients manifest acute cardiovascular complications such as intradialytic hypotension, intradialytic hypertension, arrhythmias, acute coronary syndromes and sudden death. Thus, proper management is extremely important.

Keywords: acute coronary syndrome; arrhythmia; chronic kidney disease; hemodialysis; high blood pressure; intradialytic hypotension; sudden death; unstable angina.

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Figures

Figure 1
Figure 1
The impact of cardiac flow decreases in chronic hemodialysis patients (14). IDH, intradialytic hypotension.
Figure 2
Figure 2
Intradialytic hypotension: Emergency management (38-41). UF, ultrafiltration.
Figure 3
Figure 3
Recommended measures for the prevention of IDH. IDH, Intradialytic hypotension.
See this image and copyright information in PMC

References

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