Monday, September 12, 2016

Changes in Dialysis Prescription to Reduce Risk of Intradialytic Hypotension in Hemodialysis

Intradialytic hypotension (IDH) is defined as a reduction in systolic blood pressure by more than 20 mm-Hg or a drop in mean arterial pressure by 10 mmHg. It is associated with symptoms such as yawning, nausea, abdominal discomfort, sighing, vomiting, restlessness, muscle cramps, dizziness or fainting, and others. It affects patient well-being, restricts ultrafiltration, and hikes the risk for coronary & cerebral ischemic events along with vascular access thrombosis.

Various research activities are conducted to determine effects of IDH with several other conditions. Researchers at St. Luke's International Hospital, Tokyo found that iron deficiency occurring in absence of anemia is related to intradialytic hypotension. Kenichiro Koitabashi and team carried out analysis of biochemical and clinical parameters of 99 patients on maintenance hemodialysis. 44 out of 99 patients were diagnosed with IDH. In these patients, transferrin saturation (TSAT) was found to be 18.1%. After the analysis, it was found that a TSAT level below 20% increased the risk of IDH by three-fold as compared with higher TSAT levels. “Given the effects of IDH on HD patients, our study underscores the importance of treating iron deficiency even without the presence of anemia,” the investigators concluded.

In another experiment, researchers at Fudan University, Shanghai, China found that long-term risk of death can be predicted with the help of IDH among patients on maintenance hemodialysis. A total of 117 of 293 patients were diagnosed with IDH, which researchers defined as a sudden drop in systolic blood pressure of more than 20 mmHg or in mean arterial pressure of more than 10 mmHg. Intradialytic blood pressure was monitored for a period of three months. Five-year mortality rate was noted along with effects of IDH incidence. It was observed that 84 patients died with mortality rate of 5.9% per year. It was also observed that mortality rate increased with IDH incidence. It was evident from the study that IDH increases long-term death risk.

Researchers conducted a study to examine factors related to IDH in hemodialysis patients and reduce the effects. Outcomes of the study were studied for the period of 3 months. Investigators found that over 40% of the patients had improvement in their blood pressure profile. It was observed that minor changes in dialysis prescription can reduce the incidence of IDH in patients on maintenance hemodialysis. To treat patients with frequent IDH, a careful plan of action, limiting fluid & salt, taking right amount of dose of prescription at the right time of the day, and conducting dialysis treatments on time can reduce the risk of IDH significantly.   

Analysts studying the industry have presented a thorough analysis on current market trends and future opportunities. Big Market Research has added a report, titled, “Global Intra-Dialytic Hypotension (IDH) Market Report 2016.” The report offers a comprehensive analysis of industry chain structure, industry chain structure, prominent manufacturers, and supply & sales status. 


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