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Hypotension during dialysis is a common complication in haemodialysis patients which typically occurs during the later stages of dialysis It is estimated that hypotension occurs 25 to 50 of dialysis treatments Victor and Henrich 1994 pg196- 208 Many factors involve in hypotension during dialysis including volume depletion high ultrafiltration rate autonomic dysfunction antihypertensive medications bioincompatible dialyser membrane low dialysate temperature declining serum osmolarity etc Daugirdas 1991 pg 233 However in spite of appropriate treatment many patients still suffer from hypotension during haemodialysis Collins et al 1990 when hypotension occurred the cardiac output drops sharply and there were concomitant sudden decrease in the mean arterial pressure and are attributed to a decrease venous return and considered to be caused by relocation of circulating blood possible associated a sudden decrease in venous tone which will result in hypotension The etiology and prevention of intradialytic hypotension has become an increasingly complex issue and the volume depletion due to ultrafiltration remains the predominant underlying etiologic factor Sherman et al 2002 I remembered I had one patient and many of the patients as you know dont have a lot of symptoms He was telling that he was feeling good and that and that everything was getting worse in his face I took his blood pressure and it was 7040 mmHg but the patient had none of the typical symptoms of hypotension like vomiting dizziness headache etc Ramsy et al 1999 defined hypotension of blood pressure lower than 9060 mmHg and varies from persons age time of recording and different sphygmomanometer and the way different people use the equipment can give different readings and individual tolerance Most of the staff who treat patients know that sometimes the symptoms can be quiet subtle Now Why does it happen Well normally staff will remove 2 to 4
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