Dialysis-induced hypotensionにおけるhypovolemiaの役割

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  • Role of hypovolemia in dialysis-induced hypotension

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In an attempt to determine any relationship between dialysis-induced hypotension with acute onset and circulating blood volume, we measured continuously the blood volume during hemodialysis using our own hematocrit continuous measurement system. Dialysis-induced hypotension with acute onset occurred a total of 25 times among 17 patients during 21 dialysis sessions. When the dialysis-induced hypotension occurred, there was neither a sharp decrease in blood volume nor a change in the plasma refilling rate. Hypotension resulted approximately 3 hours into dialysis in the present study. This point in time was often that at which blood volume was more than 5 percent above the minimum level during the dialysis treatment, and in some patients it was more than 10 percent above the minimum level of blood volume. These results suggest that dialysis-induced hypotension with acute onset can attribute not to a too rapid or great reduction of circulating blood volume but to a sudden breakdown of the mechanism compensating for reduction of blood volume.

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