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Hypertensive Emergency During Dialysis: A Paradoxical Physiologic Response
Steven Imburgio1, Anne Arcidiacono1, Lauren Klei1
1Internal Medicine, Jersey Shore University Medical Center, Neptune City, USA.
Cureus
|June 17, 2024
Summary
Most dialysis patients see lower blood pressure, but some experience a dangerous rise called intradialytic hypertension. This condition requires immediate medical attention and is linked to higher mortality rates.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Physiology
Background:
- End-stage renal disease (ESRD) patients commonly experience decreased blood pressure during hemodialysis.
- A rare subset of ESRD patients paradoxically exhibits elevated blood pressure during dialysis sessions.
Observation:
- A case presented with severe intradialytic hypertension, necessitating dialysis cessation and intensive care unit admission.
- This highlights the critical, though infrequently discussed, phenomenon of intradialytic hypertension.
Findings:
- The exact cause of intradialytic hypertension is not fully understood.
- Potential contributing factors include renin-angiotensin-aldosterone system activation, endothelial mediator imbalances, antihypertensive drug clearance, increased cardiac output, and arterial wall changes.
Implications:
- Intradialytic hypertension is a serious complication requiring clinical awareness.
- Elevated blood pressure during hemodialysis is associated with increased short-term and long-term mortality risks for ESRD patients.
Keywords:
case reporthemodialysishypertensive emergencyintradialytic hypertensionintradialytic hypotensionMore Related Videos
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