Effect of extracorporeal blood flow on blood pressure, pulse rate, and cardiac output in hemodialysis patients

Abstract

Background Intradialytic hypotension (IDH) is a common clinical practice to reduce the extracorporeal blood flow rate (EBFR).Aim The aim of this study is to investigate the effect of changes in EBFR on blood pressure (BP), pulse rate (PR), and cardiac output (COP) in hemodynamically stable patients during hemodialysis (HD).Patients and methods The population of this study consists of 40 patients who were on RD three session weekly. Patients were investigated before and after one conventional HD session. Before the HD session, an echocardiograph was performed to evaluate left ventricular ejection fraction and establish the degree of potential heart failure. Furthermore, arteriovenous fistula recirculation, a confounder of the measurement of EBFR, was excluded at an EBFR of 400 ml/min.Result In this study regarding measure of BP, PR, and COP at EBFR 200, 300, and 400 ml/min, there was a significant increase in systolic BP at an EBFR of 200 ml/min as compared with an EBFR of 300 ml/min and an EBFR of 400 ml/min, but there was no significant change in systolic BP at an EBFR of 300 ml/min as compared with an EBFR 400 ml/min. Regarding diastolic BP, mean arterial pressure, PR, and COP at an EBFR of 200, 300, and 400 ml/min, there was no significant change in mean arterial pressure and COP.Conclusion IDH has been associated with many adverse clinical events including myocardial stunning, cerebral atrophy, and increased mortality. Change of EBFR from 400 ml/min or from 300 ml/min to EBFR 200 ml/min can increase in BP, so it helps in decreased occurrence of complications of IDH, compared with other methods of increasing BP during HD. There is no significant relation between change of EBFR and diastolic BP.