Dialysis-associated hypotension - Revision history

ClaireLewis at 16:23, 16 October 2019

2019-10-16T16:23:50Z

← Revisión anterior		Revisión del 16:23 16 oct 2019
Línea 4:		Línea 4:
	==Clinical Features==		==Clinical Features==
	*[[Nausea/vomiting]]		*[[Nausea/vomiting]]
	*Anxiety		*[[Anxiety]]
	*Dizziness		*[[Dizziness]]
	*Orthostatic hypotension		*Orthostatic [[hypotension]]
	*[[Syncope]]		*[[Syncope]]

Línea 14:		Línea 14:
	**>20% plasma volume		**>20% plasma volume
	*Predialytic volume loss		*Predialytic volume loss
	**GI losses		**GI losses (e.g. [[vomiting]], [[diarrhea]])
	**Decreased oral intake		**Decreased oral intake
	*Intradialytic volume loss		*Intradialytic volume loss
Línea 20:		Línea 20:
	*Postdialytic volume loss		*Postdialytic volume loss
	**Vascular access blood loss		**Vascular access blood loss
	*Hemorrhage		*[[Hemorrhage]]
	*Medication effects		*Medication effects
	**Antihypertensives		**[[Antihypertensives]]
	**~~Opiates~~		**[[Opioids]]
	*Decreased vascular tone (sepsis)		*Decreased vascular tone ([[sepsis]])
	*Cardiac dysfunction		*Cardiac dysfunction
	**LVH, ischemia, hypoxia, arrhythmia, pericardial tamponade		**[[LVH]], [[myocardial ischemia\|ischemia]], [[hypoxia]], [[arrhythmia]], pericardial [[tamponade]]
	*Pericardial disease		*Pericardial disease
	**Effusion		**[[pericardial effusion\|Effusion]]
	**[[Tamponade]]		**[[Tamponade]]
	*Hemolysis		*[[Hemolytic anemia\|Hemolysis]]

	{{Dialysis complications DDX}}		{{Dialysis complications DDX}}
Línea 43:		Línea 43:

	===Evaluation by [[Hypotension]]Timing===		===Evaluation by [[Hypotension]]Timing===
	*Early in session: usually due to preexisting hypovolemia		*Early in session: usually due to preexisting [[hypovolemia]]
	*During the session: often due to blood loss (from tubing or filter leak)		*During the session: often due to blood loss (from tubing or filter leak)
	*Near the end: usually result of excessive ultrafiltration		*Near the end: usually result of excessive ultrafiltration

Ostermayer: Text replacement - "Hypotension " to "Hypotension"

2017-03-10T12:07:29Z

Text replacement - "Hypotension " to "Hypotension"

← Revisión anterior		Revisión del 12:07 10 mar 2017
Línea 42:		Línea 42:
	*GI bleeding		*GI bleeding

	===Evaluation by Hypotension Timing===		===Evaluation by [[Hypotension]]Timing===
	*Early in session: usually due to preexisting hypovolemia		*Early in session: usually due to preexisting hypovolemia
	*During the session: often due to blood loss (from tubing or filter leak)		*During the session: often due to blood loss (from tubing or filter leak)

Alvarez13 at 00:09, 21 November 2016

2016-11-21T00:09:15Z

← Revisión anterior		Revisión del 00:09 21 nov 2016
Línea 11:		Línea 11:
	==Differential Diagnosis==		==Differential Diagnosis==
	*Excessive ultrafiltration		*Excessive ultrafiltration
			**> 0.35 ml/min/kg
			**>20% plasma volume
	*Predialytic volume loss		*Predialytic volume loss
	**GI losses		**GI losses
Línea 18:		Línea 20:
	*Postdialytic volume loss		*Postdialytic volume loss
	**Vascular access blood loss		**Vascular access blood loss
			*Hemorrhage
	*Medication effects		*Medication effects
	**Antihypertensives		**Antihypertensives
Línea 26:		Línea 29:
	*Pericardial disease		*Pericardial disease
	**Effusion		**Effusion
	**Tamponade		**[[Tamponade]]
			*Hemolysis

	{{Dialysis complications DDX}}		{{Dialysis complications DDX}}

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-23T13:09:04Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Revisión anterior		Revisión del 13:09 23 jul 2016
Línea 30:		Línea 30:
	{{Dialysis complications DDX}}		{{Dialysis complications DDX}}

	==~~Diagnosis~~==		==Evaluation==
	Assess:		Assess:
	*Volume status (US)		*Volume status (US)

Rossdonaldson1: Text replacement - "tx" to "treatment"

2016-07-14T21:57:28Z

Text replacement - "tx" to "treatment"

← Revisión anterior		Revisión del 21:57 14 jul 2016
Línea 1:		Línea 1:
	==Background==		==Background==
	*Most frequent complication of hemodialysis (20%-30% of tx)		*Most frequent complication of hemodialysis (20%-30% of treatment)

	==Clinical Features==		==Clinical Features==

Neil.m.young: Text replacement - "pt's" to "patient's"

2016-06-23T00:06:16Z

Text replacement - "pt's" to "patient's"

← Revisión anterior		Revisión del 00:06 23 jun 2016
Línea 42:		Línea 42:
	*During the session: often due to blood loss (from tubing or filter leak)		*During the session: often due to blood loss (from tubing or filter leak)
	*Near the end: usually result of excessive ultrafiltration		*Near the end: usually result of excessive ultrafiltration
	**Underestimation of pt's ideal blood volume (dry weight)		**Underestimation of patient's ideal blood volume (dry weight)
	**Also consider pericardial or cardiac disease		**Also consider pericardial or cardiac disease

Ostermayer: Text replacement - "Category:Nephro" to "Category:Renal"

2016-03-22T14:08:34Z

Text replacement - "Category:Nephro" to "Category:Renal"

← Revisión anterior		Revisión del 14:08 22 mar 2016
Línea 57:		Línea 57:
	<references/>		<references/>

	[[Category:~~Nephro~~]]		[[Category:Renal]]

Rossdonaldson1 at 13:31, 28 June 2015

2015-06-28T13:31:25Z

← Revisión anterior		Revisión del 13:31 28 jun 2015
Línea 1:		Línea 1:
	==Background==		==Background==
	*Most frequent complication of hemodialysis (20%-30% of tx)		*Most frequent complication of hemodialysis (20%-30% of tx)
	*Timing of intradialytic hypotension is helpful in formulating DDX:
	**Hypotension early in session usually due to preexisting hypovolemia
	**Hypotension during the session is often due to blood loss (from tubing or filter leak)
	**Hypotension near the end usually result of excessive ultrafiltration
	***Underestimation of pt's ideal blood volume (dry weight)
	***Also consider pericardial or cardiac disease

	==Clinical Features==		==Clinical Features==
	*N/V		*[[Nausea/vomiting]]
	*Anxiety		*Anxiety
	*Dizziness		*Dizziness
	*Orthostatic hypotension		*Orthostatic hypotension
	*Syncope		*[[Syncope]]

	==Diagnosis==		==Differential Diagnosis==
	~~#Assess:~~		*Excessive ultrafiltration
	~~##Volume status~~ (US)		*Predialytic volume loss
	##Cardiac ~~function~~		**GI losses
	##Pericardial disease		**Decreased oral intake
	~~##Infection~~		*Intradialytic volume loss
	~~##GI bleeding~~		**Tube and hemodialyzer blood losses
			*Postdialytic volume loss
			**Vascular access blood loss
			*Medication effects
			**Antihypertensives
			**Opiates
			*Decreased vascular tone (sepsis)
			*Cardiac dysfunction
			**LVH, ischemia, hypoxia, arrhythmia, pericardial tamponade
			*Pericardial disease
			**Effusion
			**Tamponade

	~~==Differential Diagnosis==~~
	~~#Excessive ultrafiltration~~
	~~#Predialytic volume loss~~
	~~##GI losses~~
	~~##Decreased oral intake~~
	~~#Intradialytic volume loss~~
	~~##Tube and hemodialyzer blood losses~~
	~~#Postdialytic volume loss~~
	~~##Vascular access blood loss~~
	~~#Medication effects~~
	~~##Antihypertensives~~
	~~##Opiates~~
	~~#Decreased vascular tone (sepsis)~~
	~~#Cardiac dysfunction~~
	~~##LVH, ischemia, hypoxia, arrhythmia, pericardial tamponade~~
	~~#Pericardial disease~~
	~~##Effusion~~
	~~##Tamponade~~
	{{Dialysis complications DDX}}		{{Dialysis complications DDX}}

	==~~Workup~~==		==Diagnosis==
			Assess:
			*Volume status (US)
			*Cardiac function
			*Pericardial disease
			*Infection
			*GI bleeding

			===Evaluation by Hypotension Timing===
			*Early in session: usually due to preexisting hypovolemia
			*During the session: often due to blood loss (from tubing or filter leak)
			*Near the end: usually result of excessive ultrafiltration
			**Underestimation of pt's ideal blood volume (dry weight)
			**Also consider pericardial or cardiac disease

	==Management==		==Management==
Línea 54:		Línea 54:
	==External Links==		==External Links==

	==~~Sources~~==		==References==
	<references/>		<references/>

	[[Category:Nephro]]		[[Category:Nephro]]

Rossdonaldson1: /* Differential Diagnosis */

2014-12-12T06:02:22Z

Differential Diagnosis

← Revisión anterior		Revisión del 06:02 12 dic 2014
Línea 41:		Línea 41:
	##Effusion		##Effusion
	##Tamponade		##Tamponade
			{{Dialysis complications DDX}}

	==Workup==		==Workup==

Rossdonaldson1: /* See Also */

2014-12-11T16:18:37Z

← Revisión anterior		Revisión del 16:18 11 dic 2014
Línea 49:		Línea 49:

	==See Also==		==See Also==
			*[[Dialysis complications]]

	==External Links==		==External Links==