[Intradialytic hypotension: The role of volemia]

Intradialytic hypotension (IDH) is one of the most serious complications in renal replacement therapy (RRT). The main cause of IDH is hypovolemia due to an imbalance between the amount of fluid removed and the refilling capacity of the intravascular compartment. IDH occurs when compensatory mechanisms for hypovolemia are overwhelmed by excessive fluid removal. As long as RRT is limited to only a few hours per week, IDH will continue to be a relevant problem. Research has focused mainly on enlarging the compensatory capacity for ultrafiltration-induced hypovolemia. This review critically discusses the technical approaches that have been recently introduced to the therapy with the promise of reducing hypovolemia-induced IDH.