Table 1.
Risk factors for Intradialytic Hypotension
| Risk Factor | Reference | Effect on Intradialytic Hypotension | Comments |
|---|---|---|---|
|
| |||
| Patient-related Factors | |||
|
| |||
| Demographics | |||
|
| |||
| Increasing age | Tisler 2003 | + | |
| Sands 2014 | + | ||
| Male sex | Tisler 2003 | − | |
| Sands 2014 | − | ||
| Hispanic ethnicity | Sands 2014 | + | |
| Longer hemodialysis vintage | Sands 2014 | + | |
|
| |||
| Co-Morbid Disease | |||
|
| |||
| Diabetes mellitus | Sands 2014 | + | Systolic Dysfunction LVH Elevated cardiac Tn |
| Takeda 2006 | + | ||
| Coronary artery disease | Tisler 2003 | + | |
| Cardiac Dysfunction | Van der Sande 1998 | + | |
| Chao 2015 | + | ||
| Hung 2014 | + | ||
|
| |||
| Other Patient Factors | |||
|
| |||
| Hyperphosphatemia | Tisler 2003 | + | CCB, nitrate use |
| Anti-hypertensive medications | Tisler 2003 | + | |
| Takeda 2006 | − | ||
| Higher BMI | Sands 2014 | + | |
| Lower albumin | Nakamoto 2006 | + | |
| Diuretic Use | Tisler 2003 | − | |
|
| |||
| Hemodialysis-related Factors | |||
|
| |||
| Increased IDWG | Stefansson 2014 | + | |
| Takeda 2006 | + | ||
|
| |||
| Lower pre-dialysis BP | Sands 2014 | + | |
| Takeda 2006 | − | ||
|
| |||
| Increased UFR | Sands 2014 | + | >10mL/hr/kg increases risk |
| Van der Sande 1998 | + | ||
| Flythe 2011 | + | >13mL/hr/kg highest risk | |
| Movilli 2007 | + | ||
| Saran 2006 | + | ||
|
| |||
| Lower dialysate sodium | Levine 1978 | − | Dialysate Na ≤135 mmol/L |
| Raja 1983 | − | ||
| Steward 1972 | − | ||
|
| |||
| Lower dialysate calcium | Kyriazis 2000 | + | |
|
| |||
| Acetate buffer | Noris 1998 | + | |
|
| |||
| Longer interdialytic interval | Sands 2014 | + | |
LVH: Left ventricular hypertrophy; Tn: troponin; BMI: body mass index; IDWG: interdialytic weight gain; BP: blood pressure; UFR: ultrafiltration rate; CCB: calcium channel blocker