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Management of acute intradialytic cardiovascular complications: Updated overview (Review)
Delia Timofte1, Maria-Daniela Tanasescu2,3, Daniela Gabriela Balan4
1Department of Dialysis, Emergency University Hospital, 050098 Bucharest, Romania.
Insights
Chronic kidney disease (CKD) impacts many globally, with patients often experiencing cardiovascular damage and acute complications during dialysis. Effective management is crucial to reduce morbidity and mortality in these high-risk individuals.
Area of Science:
- Nephrology
- Cardiology
- Public Health
Background:
- Chronic kidney disease (CKD) is a significant global health issue affecting a large population.
- Key risk factors for CKD include diabetes mellitus, hypertension, and family history.
- Advanced CKD is associated with substantial cardiovascular damage and multiple comorbidities.
Purpose of the Study:
- To highlight the prevalence and impact of cardiovascular complications in CKD patients.
- To underscore the importance of managing comorbidities in CKD patients.
- To emphasize the critical need for proper management during dialysis to mitigate acute cardiovascular events.
Main Methods:
- Review of existing literature on CKD, its risk factors, and associated cardiovascular complications.
- Analysis of comorbidities common in CKD patients, including hypertension, hyperlipidemia, and mineral-bone disorders.
- Examination of acute cardiovascular complications frequently observed during hemodialysis.
Main Results:
- CKD patients exhibit significant cardiovascular damage and a high burden of comorbidities.
- Acute cardiovascular complications, such as hypotension, hypertension, and arrhythmias, are frequent during dialysis.
- These intradialytic cardiovascular events significantly influence patient morbidity and mortality rates.
Conclusions:
- Cardiovascular complications represent a major threat to CKD patients undergoing dialysis.
- Comprehensive management of CKD and its associated comorbidities is essential.
- Vigilant monitoring and intervention during dialysis are critical for improving patient outcomes.
Abstract:
An increasing number of patients require renal replacement therapy through dialysis and renal transplantation. Chronic kidney disease (CKD) affects a large percentage of the world's population and has evolved into a major public health concern. Diabetes mellitus, high blood pressure and a family history of kidney failure are all major risk factors for CKD. Patients in advanced stages of CKD have varying degrees of cardiovascular damage. Comorbidities of these patients, include, on the one hand, hypertension, hyperlipidemia, hyperglycemia, hyperuricemia and, on the other hand, the presence of mineral-bone disorders associated with CKD and chronic inflammation, which contribute to cardiovascular involvement. Acute complications occur quite frequently during dialysis. Among these, the most important are cardiovascular complications, which influence the morbidity and mortality rates of this group of patients. Chronic hemodialysis patients manifest acute cardiovascular complications such as intradialytic hypotension, intradialytic hypertension, arrhythmias, acute coronary syndromes and sudden death. Thus, proper management is extremely important.
