Intradialytic hypotension prevalence, influencing factors, and nursing interventions: prospective results of 744 hemodia
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ORIGINAL ARTICLE
Intradialytic hypotension prevalence, influencing factors, and nursing interventions: prospective results of 744 hemodialysis sessions Nurten Ozen 1
&
Tugba Cepken 2
Received: 5 April 2020 / Accepted: 3 May 2020 # Royal Academy of Medicine in Ireland 2020
Abstract Introduction The aim of this study was to evaluate intradialytic hypotension (IDH) prevalence, influencing factors, and nursing interventions in hemodialysis (HD) patients. Methods This descriptive and cross-sectional study was conducted at a private dialysis center. The patients were followed-up in terms of IDH development based on the European Best Practice Guidelines criteria during six consecutive HD sessions. The study followed the STROBE checklist. Results A total of 744 hemodialysis sessions of 124 patients were monitored. IDH developed in 51.6% of the patients and the prevalence was 17.60%. The most common nursing interventions were stopping ultrafiltration and isotonic saline solution administration. White blood cell (WBC) (p = 0.017) and creatinine (p = 0.005) values were statistically significantly higher in patients developing IDH. WBC was found to increase IDH development risk 0.796 times (95% CI [0.657–0.996], p = 0.021). Conclusion Nursing staff awareness regarding the frequency of IDH in hemodialysis patients and the related symptoms needs to be increased. Keywords European Best Practice Guidelines . Hemodialysis . Intradialytic hypotension . White blood cell
Introduction Intradialytic hypotension (IDH) is one of the important common hemodialysis (HD) complications and increases morbidity and mortality [1, 2]. It can also lead to deterioration of the patient’s quality of life [2], decreased residual renal function and systemic damage in the brain, gastrointestinal tract and heart [3], thrombosis development in the vascular access route, and decreased dialysis adequacy [4]. The incidence of IDH is 4–69% in the literature [1, 5, 6]; recurrent IDH can lead to mesenteric ischemia and Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11845-020-02249-9) contains supplementary material, which is available to authorized users. * Nurten Ozen [email protected] 1
Florence Nightingale Hospital School of Nursing, Demiroglu Bilim University, Istanbul, Turkey
2
Private Esenyurt Dialysis Center, Istanbul, Turkey
endotoxemia, secretion of pro-inflammatory cytokines such as interleukin-6 and C-reactive protein (CRP), endothelial dysfunction, and consequently an increase in the risk of cardiovascular disease [7]. Symptoms such as muscle cramps, fatigue, weakness, nausea, vomiting, dizziness, and loss of consciousness can have life-threatening effects [4]. The detection of IDH can prevent the occurrence of undesirable side effects and improve the patient’s quality of life [8]. Dialysis patients are more sensitive to decreases in blood pressure compared with the healthy population [9]. The decrease in blood volume due to ultrafiltration (UF) is the main factor leading to IDH developme
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