Title

Measuring the prevalence of intradialytic hypotension in a satellite dialysis clinic: Are we too complacent?

Document Type

Journal Article

Publisher

Blackwell Publishing Ltd

School

School of Nursing

Comments

Originally published as:

Steinwandel, U., Gibson, N., Towell‐Barnard, M., Parsons, R., Rippey, J. J. R., & Rosman, J. (2018). Measuring the prevalence of intradialytic hypotension in a satellite dialysis clinic: Are we too complacent?. Journal of Clinical Nursing, 27, e1561-e1570. doi:10.1111/jocn.14309

Original article available here.

Abstract

Aims and objectives

To measure the prevalence of symptomatic (S‐IDH) and asymptomatic intradialytic hypotension (A‐IDH) or postdialysis overhydration in a satellite haemodialysis clinic in Western Australia.

Background

Intradialytic hypotension is one of the most common side effects of haemodialysis caused by ultrafiltration provoking a temporary volume depletion. The prevalence of asymptomatic hypotension during dialysis has been rarely reported, but is considered to have the same negative consequences as symptomatic hypotension on various end organs like the brain and the gastrointestinal tract.

Design

Observational study on a retrospective 3‐month period of nursing recorded fluid‐related adverse events.

Methods

Data collection on the occurrence of S‐IDH and A‐IDH during a total of 2,357 haemodialysis treatments in 64 patients. Body weight of patients at the time of cessation of treatment was recorded, and patients, whose weight exceeded their ideal body weight by at least 0.5 kg, were classified as overhydrated.

Data analysis was performed using spss version 24 software.

Results

Symptomatic intradialytic hypotension was the most common adverse event measured in this cohort, and occurred during 221 (9.4%) of all treatments, whereas asymptomatic intradialytic hypotension occurred in 88 (3.7%) of all treatments. The total occurrence of intradialytic hypotension was 13.1%, and symptomatic was observed in 30 patients, implying that nearly every second patient had at least one symptomatic episode within 3 months. Overhydration occurred in a total of 103 (4.4%) of all treatments, and involved 17 patients.

Conclusions

Symptomatic and asymptomatic intradialytic hypotension were the most commonly observed adverse events in this cohort; overhydration occurrence was considerably less common.

Relevance to clinical practice

The high occurrence of hypotension‐related events demonstrates that ultrafiltration treatment goals in satellite dialysis clinics are sometimes overestimated, resulting in regular significant symptomatic episodes for the patient. Raising the awareness of the prevalence of IDH amongst renal nurses could be an essential initial step before collectively preventative strategies in haemodialysis satellite units are implemented.

DOI

10.1111/jocn.14309

Access Rights

Free_to_read

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