Strategies for improving hemodynamic stability in cardiac-compromised dialysis patients

In hemodialysis patients, structural changes at ail levels of the cardiovas cular system are common, The presence of these cardiovascular changes is a risk factor for the development of intradialytic hypotension, This explains the clinical observation that the incidence of symptomatic hypotension is high in elderly hemodialysis patients, who often have a history of long-sta nding hypertension and atherosclerosis, and in hemodialysis patients with c ardiovascular disease. With an increasing number of cardiovascular compromi sed dialysis patients, special attention should be given to this group of p atients, As the age of patients on hemodialysis Increases steadily, it is a challenge to provide comfortable treatment in these patients by reducing t he incidence of symptomatic hypotensive periods. This article describes the use of relatively new and simple clinical maneuvers to reduce the incidenc e of symptomatic hypotension, (C) 2000 by the National Kidney Foundation, I nc.