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International Urology and Nephrology

Erschienen in:

29.10.2022 | Nephrology - Review

An update review on hemodynamic instability in renal replacement therapy patients

verfasst von: Abdullah B. Yildiz, Sezan Vehbi, Andreea Covic, Alexandru Burlacu, Adrian Covic, Mehmet Kanbay

Erschienen in: International Urology and Nephrology | Ausgabe 4/2023

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Abstract

Background

Hemodynamic instability in patients undergoing kidney replacement therapy (KRT) is one of the most common and essential factors influencing mortality, morbidity, and the quality of life in this patient population.

Method

Decreased cardiac preload, reduced systemic vascular resistance, redistribution of fluids, fluid overload, inflammatory factors, and changes in plasma osmolality have all been implicated in the pathophysiology of hemodynamic instability associated with KRT.

Result

A cascade of these detrimental mechanisms may ultimately cause intra-dialytic hypotension, reduced tissue perfusion, and impaired kidney rehabilitation. Multiple parameters, including dialysate composition, temperature, posture during dialysis sessions, physical activity, fluid administrations, dialysis timing, and specific pharmacologic agents, have been studied as possible management modalities. Nevertheless, a clear consensus is not reached.

Conclusion

This review includes a thorough investigation of the literature on hemodynamic instability in KRT patients, providing insight on interventions that may potentially minimize factors leading to hemodynamic instability.

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Titel: An update review on hemodynamic instability in renal replacement therapy patients
verfasst von: Abdullah B. Yildiz
Sezan Vehbi
Andreea Covic
Alexandru Burlacu
Adrian Covic
Mehmet Kanbay
Publikationsdatum: 29.10.2022
Verlag: Springer Netherlands
Erschienen in: International Urology and Nephrology / Ausgabe 4/2023
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584
DOI: https://doi.org/10.1007/s11255-022-03389-w

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