Mechanism of dialysis-induced hypotension.

Dialysis-induced hypotension, the sharp decrease in blood pressure occurring during hemodialysis, remains one of the most difficult problems associated with hemodialysis even today. However, there is yet no established theory to explain the mechanism triggering dialysis-induced hypotension. This review attempts to offer a consistent and cohesive source of information on the hemodynamics during dialysis-induced hypotension, and then analyzes etiologic factors in such hypotension reported by various investigators. Finally, three hypotheses concerning the mechanism of dialysis-induced hypotension including our own are introduced.

[1]  A. Santoro,et al.  Autonomic function in hemodialyzed patients. , 1978, The International journal of artificial organs.

[2]  C. Zoccali,et al.  Effect of extracorporeal blood cooling on dialytic arterial hypotension. , 1981, Proceedings of the European Dialysis and Transplant Association. European Dialysis and Transplant Association.

[3]  J. Woolliscroft,et al.  Increased body fluid purine levels during hypotensive events. Evidence for ATP degradation. , 1986, The American journal of medicine.

[4]  G. Brengelmann Circulatory adjustments to exercise and heat stress. , 1983, Annual review of physiology.

[5]  C. Colton,et al.  Transcellular urea gradients cause minimal depletion of extracellular volume during hemodialysis. , 1989, ASAIO transactions.

[6]  M. Norusis,et al.  Hemodynamic response to volume depletion in acutely uremic dogs. , 1984, American Journal of Physiology.

[7]  R. Tarazi,et al.  Localization of autonomic nervous system dysfunction in dialysis patients. , 1987, American journal of nephrology.

[8]  Hemodynamic and Metabolic Effects of Hemorrhage in Man, with Particular Reference to the Splanchnic Circulation , 1966 .

[9]  U. Schallenberg,et al.  Characteristic profiles of circulating blood volume during dialysis therapy. , 1989, ASAIO Transactions.

[10]  P. Degoulet,et al.  Hemodynamic evaluation of hypotension during chronic hemodialysis. , 1977, Clinical nephrology.

[11]  D. Kunze,et al.  Sodium Sensitivity of Baroreceptors: Reflex Effects on Blood Pressure and Fluid Volume in the Cat , 1978, Circulation research.

[12]  L. Lins,et al.  Biocompatibility of dialysis membranes is of no importance for objective or subjective symptoms during or after hemodialysis. , 1990, ASAIO transactions.

[13]  J. Woolliscroft,et al.  Hyperuricemia in acute illness: a poor prognostic sign. , 1982, The American journal of medicine.

[14]  E. Ushioda,et al.  The contribution of the beta-adrenergic system to the cardiovascular response to hypovolemia. , 1983, American journal of obstetrics and gynecology.

[15]  F. Gotch,et al.  An analysis of thermal regulation in hemodialysis with one and three compartment models. , 1989, ASAIO transactions.

[16]  A. Krogh The Regulation of the Supply of Blood to the Right Heart1 , 1912 .

[17]  E R Nadel,et al.  Effect of hydration state of circulatory and thermal regulations. , 1980, Journal of applied physiology: respiratory, environmental and exercise physiology.

[18]  U. Coli,et al.  Cold as cardiovascular stabilizing factor in hemodialysis: hemodynamic evaluation. , 1983, Transactions - American Society for Artificial Internal Organs.

[19]  E. Atkins Fever--new perspectives on an old phenomenon. , 1983, The New England journal of medicine.

[20]  L. Henderson,et al.  Hemodialysis Hypotension: The Interleukin Hypothesis , 1983 .

[21]  L. Pedrini,et al.  Causes, kinetics and clinical implications of post-hemodialysis urea rebound. , 1988, Kidney international.

[22]  H. Neumayer,et al.  Prostaglandin E2 promotes hypotension on low-sodium hemodialysis. , 1984, Nephron.

[23]  E. Nadel,et al.  Effect of acute alterations of blood volume on circulatory performance in humans. , 1981, Journal of applied physiology: respiratory, environmental and exercise physiology.

[24]  S. Shaldon,et al.  Vascular stability during high flux haemofiltration (HF). , 1979, Proceedings of the European Dialysis and Transplant Association. European Dialysis and Transplant Association.

[25]  S. Nakai,et al.  Relationship between dialysis induced hypotension and adenosine released by ischemic tissue. , 1992, ASAIO journal.

[26]  R. Cody,et al.  Postprandial blood pressure changes during hemodialysis. , 1988, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[27]  C. Chou,et al.  Adenosine plays a role in food-induced jejunal hyperemia. , 1988, The American journal of physiology.

[28]  J. T. Shepherd,et al.  Inhibition of Sympathetic Neurotransmission in Canine Blood Vessels by Adenosine and Adenine Nucleotides , 1977, Circulation research.

[29]  D. Chenoweth Complement activation during hemodialysis: clinical observations, proposed mechanisms, and theoretical implications. , 1984, Artificial organs.

[30]  C. Dinarello,et al.  Molecular basis of fever in humans. , 1982, The American journal of medicine.

[31]  A. Cheung,et al.  Anaphylatoxin formation during hemodialysis: effects of different dialyzer membranes. , 1983, Kidney international.

[32]  S. de Jager Experiments and Considerations on Haemodynamics , 1886, The Journal of physiology.

[33]  K. Cohn,et al.  Autonomic insufficiency in uremia as a cause of hemodialysis-induced hypotension. , 1974, The New England journal of medicine.

[34]  J. V. van Stone,et al.  The effect of dialysate sodium concentration on body fluid distribution during hemodialysis. , 1980, Transactions - American Society for Artificial Internal Organs.

[35]  J. Daugirdas,et al.  Ultrafiltration hemodynamics in an animal model: effect of a decreasing plasma sodium level. , 1984, Transactions - American Society for Artificial Internal Organs.

[36]  C. Kjellstrand,et al.  Plasma concentrations of calcitonin gene‐related peptide increase during haemodialysis: relation to blood pressure * , 1989, Journal of internal medicine.

[37]  R. Stone,et al.  Adrenergic regulation of blood pressure in chronic renal failure. , 1976, The Journal of clinical investigation.

[38]  A. Johns,et al.  Presynaptic inhibitory actions of adenine nucleotides and adenosine on neurotransmission in the rat vas deferens , 1977, Neuroscience.

[39]  D. Chenoweth,et al.  Demonstration of a specific receptor for human C5a anaphylatoxin on murine macrophages , 1982, The Journal of experimental medicine.

[40]  E. Constantini,et al.  The influence of ultrafiltration (UF) and diffusion (D) on cardiovascular parameters. , 1980, Transactions - American Society for Artificial Internal Organs.

[41]  C. Zoccali,et al.  Blood temperature and vascular stability during hemodialysis and hemofiltration. , 1982, Transactions - American Society for Artificial Internal Organs.

[42]  L. Rowell,et al.  Human cardiovascular adjustments to exercise and thermal stress. , 1974, Physiological reviews.

[43]  S. Levison,et al.  Content and distribution of water and electrolytes in maitenance hemodialysis. , 1975, Nephron.

[44]  D J Ewing,et al.  Autonomic function in patients with chronic renal failure on intermittent haemodialysis. , 1975, Nephron.

[45]  Gisolfi Cv,et al.  Temperature Regulation During Exercise: Old Concepts, New Ideas , 1984, Exercise and sport sciences reviews.

[46]  J. Daugirdas,et al.  Acetate relaxation of isolated vascular smooth muscle. , 1987, Kidney international.

[47]  D. Chenoweth,et al.  Induction of interleukin 1 secretion and enhancement of humoral immunity by binding of human C5a to macrophage surface C5a receptors , 1982, The Journal of experimental medicine.

[48]  C. Mathias,et al.  Relationship between splanchnic vasodilation and postprandial hypotension in patients with primary autonomic failure. , 1989, Journal of hypertension. Supplement : official journal of the International Society of Hypertension.

[49]  R. Schnaar,et al.  Response of large and small coronary arteries to nitroglycerin, NaNO 2 , and adenosine. , 1972, The American journal of physiology.

[50]  V. Campese,et al.  Mechanisms of autonomic nervous system dysfunction in uremia. , 1981, Kidney international.

[51]  T. Pickering,et al.  Baroreflex sensitivity in patients on long-term haemodialysis. , 1972, Clinical science.

[52]  S. Vatner,et al.  Cardiac Dynamics during Hemorrhage: Relative Unimportance of Adrenergic Inotropic Responses , 1982, Circulation research.

[53]  K. Maeda,et al.  Change in sympathetic activity before, during, and after dialysis-induced hypotension. , 1990, ASAIO transactions.

[54]  T Shinzato,et al.  Role of hypovolemia in dialysis-induced hypotension. , 1988, Artificial organs.

[55]  S. Gore,et al.  Is dialysis hypotension caused by an abnormality of venous tone? , 1988, British medical journal.

[56]  D. Robertson,et al.  Hemodialysis hypotension is not the result of uremic peripheral autonomic neuropathy. , 1979, The Journal of laboratory and clinical medicine.

[57]  G Kimura,et al.  Model prediction of plasma volume change induced by hemodialysis. , 1984, The Journal of laboratory and clinical medicine.

[58]  K. Maeda,et al.  Mechanism of dialysis-induced hypotension. , 1992, ASAIO transactions.

[59]  L. Rowell Human Circulation: Regulation During Physical Stress , 1986 .

[60]  C. Rothe,et al.  Reflex control of veins and vascular capacitance. , 1983, Physiological reviews.

[61]  M. Creager,et al.  Regional vascular responses to prolonged lower body negative pressure in normal subjects. , 1989, The American journal of physiology.

[62]  C. Zoccali,et al.  Postprandial alterations in arterial pressure control during hemodialysis in uremic patients. , 1989, Clinical Nephrology.

[63]  E. Lowrie,et al.  Baroreceptor Activity in Normotensive and Hypertensive Uremic Patients , 1973, Circulation.

[64]  S. Vatner,et al.  Relative roles of cardiac receptors and arterial baroreceptors during hemorrhage in conscious dogs. , 1990, Circulation research.

[65]  R. Cody,et al.  The effect of red cell transfusion on hemodialysis-related hypotension. , 1988, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[66]  T. Ing,et al.  Fluid removal with negative-pressure hydrostatic ultrafiltration using a partial vacuum. , 1975, Nephron.

[67]  C. Nutting,et al.  Acetate causes endothelium-independent increases in cyclic AMP in rat caudal artery. , 1988, The American journal of physiology.

[68]  K. Koch,et al.  Comparison of haemodialysis (HD) and post dilution haemofiltration (HF) on an unselected dialysis population. , 1978, Proceedings of the European Dialysis and Transplant Association. European Dialysis and Transplant Association.

[69]  A. Bertulla,et al.  Hemodynamic changes during acetate dialysis, bicarbonate dialysis and hemofiltration. , 1988, Blood Purification.