Intradialytic hypotension and cardiac remodeling: A vicious cycle
Journal
BioMed Research International
Journal Volume
2015
Pages
724147
Date Issued
2015
Author(s)
Abstract
Hemodynamic instability during hemodialysis is a common but often underestimated issue in the nephrologist practice. Intradialytic hypotension, namely, a decrease of systolic or mean blood pressure to a certain level, prohibits the safe and smooth achievement of ultrafiltration and solute removal goal in chronic dialysis patients. Studies have elucidated the potential mechanisms involved in the development of Intradialytic hypotension, including excessive ultrafiltration and loss of compensatory mechanisms for blood pressure maintenance. Cardiac remodeling could also be one important piece of the puzzle. In this review, we intend to discuss the role of cardiac remodeling, including left ventricular hypertrophy, in the development of Intradialytic hypotension. In addition, we will also provide evidence that a bidirectional relationship might exist between Intradialytic hypotension and left ventricular hypertrophy in chronic dialysis patients. A more complete understanding of the complex interactions in between could assist the readers in formulating potential solutions for the reduction of both phenomena. ? 2015 Chia-Ter Chao et al.
SDGs
Other Subjects
bicarbonate; carnitine; iron; vasopressin; vitamin D; cardiovascular disease; coronary artery; drug efficacy; drug infusion; end stage renal disease; heart atrium enlargement; heart atrium fibrillation; heart left atrium; heart left ventricle hypertrophy; heart muscle fibrosis; heart muscle perfusion; heart ventricle remodeling; hemodialysis; hemodialysis patient; hospitalization; human; hypotension; intradialytic hypotension; iron therapy; nutritional deficiency; renin angiotensin aldosterone system; Review; risk factor; stunned heart muscle; ultrafiltration; adverse effects; biological model; chronic kidney failure; complication; heart left ventricle hypertrophy; hypotension; pathology; pathophysiology; renal replacement therapy; Humans; Hypertrophy, Left Ventricular; Hypotension; Kidney Failure, Chronic; Models, Biological; Renal Dialysis; Ventricular Remodeling
Publisher
Hindawi Limited
Type
review