Table 2.

Clinical guidelines for intradialytic hypotension prevention.[19]

First-line

Dietary counselling (sodium restriction)

Avoidance of food ingestion during dialysis

Clinical reassessment of target weight

Use of bicarbonate dialysis buffer

Use of dialysate temperature of 36.5°C

Review of dosing and timing of antihypertensives

Second-line

Objective measures for reassessment of target weight

Cardiac evaluation

Gradual reduction of dialysate temperature (lowest 35°C)

Individualized blood volume controlled feedback

Increased dialysis treatment time or extra treatment

Third-line

Midodrine

L-carnitine supplementation

Dialysis modality change