Table 1.
Patient factors which potentially increase the risk of intradialytic hypotension
| Risk factors | Pathology | At risk groups |
|---|---|---|
| Normal plasma volume | Pulmonary hypertension | Chronic lung disease |
| High flow A-V shunt | ||
| Pericardial effusion | Cardiac tamponade | |
| Right ventricular dysfunction | Inferior myocardial infarction | |
| Heart failure with preserved ejection fraction | Diastolic dysfunction | |
| Cardiac conduction defect | Complete heart block | |
| Infiltrative cardiomyopathy | Amyloid | |
| Reduced plasma volume | Hemorrhage | Acute blood loss |
| Diarrhea | Gastroenteritis | |
| Vomiting | Gastric outflow obstruction | |
| Sodium losing nephropathy | Posterior urethral valves | |
| Reduced effective plasma volume | Systemic sepsis | Bacterial infection |
| Liver failure | Acute on chronic liver failure | |
| Anemia | Chronic kidney disease | |
| Hypoalbuminemia | Malnutrition & sepsis | |
| Cardiac afterload | Heart failure with reduced ejection fraction | Ischemic heat disease |
| Cardiomyopathy | ||
| Valvular heart disease | Aortic stenosis | |
| Autonomic dysfunction | Age | Elderly |
| Endocrine/metabolic | Diabetes | |
| Thyroid disease | ||
| Porphyria | ||
| Autoimmune | Systemic lupus erythematosus | |
| Sjogrens syndrome | ||
| Coeliac disease | ||
| Infiltrative | Amyloid | |
| Neurologic | Parkinson’s disease | |
| Life style | Alcohol | |
| Malignancy | Paraneoplastic | |
| Bortezomib | ||
| Doxorubicin | ||
| Sympathetic denervation | Cardiac transplant | |
| Artificial heart | ||
| Medications | Atenolol/metoprolol/propranolol/timolol | |
| Methyl dopa | ||
| Alpha blockers |
A-V, arterio-venous.
Predominantly because of reduced cardiac reserve to repond to a reduction in cardiac filling pressures and autonomic dysfunction AV shunt.