Hypotension in patients on chronic peritoneal dialysis: etiology, management, and outcome.
نویسندگان
چکیده
We retrospectively evaluated the phenomenon of arterial hypotension in peritoneal dialysis (PD) in a large cohort of 633 PD patients from two centers (Toronto Western Hospital, Toronto, Canada, and Division of Nephrology, Democritus University of Thrace, Greece), thus extending our previously reported experience for an additional 6 years (1995-2000). Together, the units had 81 hypotensive patients (12.8%), whose mean age was 63.8 +/- 14.2 years and whose mean duration of peritoneal dialysis was 49.3 +/- 30 months. Based on the underlying pathophysiology, the hypotensive PD patients were divided into four groups: (A) hypovolemia, 32 patients (39.5%); (B) congestive heart failure (CHF), 15 patients (18.5%); (C) receiving antihypertensive medications, 11 patients (13.6%); and (D) "unknown" etiology, 23 patients (28.4%). All patients in the hypovolemic and antihypertensive groups responded well to treatment (volume expansion and discontinuation of antihypertensive medication, respectively), but in the CHF and "unknown" groups, only 40% improved with the appropriate intervention. Patients in the latter two groups showed the poorest prognosis, with an approximate death rate of 65%. The hypovolemic group had better outcomes, which might reflect prompt response to fluid replacement in that group. We conclude that, in PD patients, careful use of antihypertensive medication, the right evaluation of target weight (especially in patients with cardiac failure), and judicious use of hypertonic exchanges may prevent the severe complication of arterial hypotension.
منابع مشابه
Etiology and Outcome of Chronic Kidney Disease in Iranian Children
Background Considering the significant geographical and ethnical differences in pattern of incidence, etiology and outcome of chronic kidney disease (CKD), the present study aimed to assess the etiology and outcome of CKD in Iranian children. Materials and Methods In a cross-sectional study etiology and outcome of 372 children aged 3 months to 18 years with CKD was studied during the period 199...
متن کاملHypotension in Infants on Chronic Peritoneal Dialysis: Mechanisms, Complications, and Management.
Hypotension represents a very serious clinical problem in patients receiving renal replacement therapy, and it is associated with a significant increase in mortality risk. Infants on chronic peritoneal dialysis (CPD) can be particularly prone to chronic hypotension because of the hyponatremic hypovolemia risk related to their primary renal disease, their nutritional needs, and their peritoneal ...
متن کاملگزارش سه مورد CVVHD) Continous Venovenous Hemodialysis)
Some of ICU patients with Acute Renal Failure (ARF) require dialysis. Conventional or intermittent hemodialysis (HD) may cause hypotension and insufficient loss of fluids and toxins from blood. Peritoneal dialysis also my cause peritonitis and has lower efficiency than HD. We did continuous Venovenous Hemodialysis (CVVHD) for three ICU patients with ARF in Saint-Zahra Medical Center for the fir...
متن کاملبقا و عوارض کاتترهای دیالیز صفاقی: معرفی یک روش لاپاروسکوپی با بیحسی موضعی
Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 !mso]> st1":*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal" mso-tst...
متن کاملCorrelational studies on insulin resistance and leptin gene polymorphisms in peritoneal dialysis patients
Objective(s):The aim of the study was to investigate the relationship between insulin resistance (IR) and leptin (LEP) gene polymorphisms in peritoneal dialysis (PD) patients. Materials and Methods: From July 1, 2011 to August 1, 2011, patients who received chronic PD were chosen and divided into three groups (DM, high HOMR-IR, and low HOMR-IR). Two PCR products of LEP were sequenced and aligne...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Advances in peritoneal dialysis. Conference on Peritoneal Dialysis
دوره 18 شماره
صفحات -
تاریخ انتشار 2002