Hypotension mu dialysis ndeimwe yematambudziko akajairika muhemodialysis.Zvinoitika nekukasira uye kazhinji zvinoita kuti hemodialysis ikundikane zvakanaka, zvichikonzera kusakwana kwedialysis, kukanganisa kushanda uye kunaka kwedialysis, uye kunyange kutyisidzira hupenyu hwevarwere mumatambudziko akakomba.
Kusimbisa uye kutarisisa kudzivirira uye kurapwa kwe hypotension mu dialysis varwere kwakakosha zvikuru kuvandudza mwero wekupona uye hupenyu hwehupenyu hwekuchengetedza hemodialysis varwere.

Chii chinonzi dialysis medium low blood pressure

• Tsanangudzo

Hypotension pa dialysis inotsanangurwa sekudonha kwe systolic blood pressure yakakura kupfuura 20mmHg kana kudonha kweane arterial blood pressure yakakura kupfuura 10mmHg, maererano ne2019 edition yeazvino KDOQI (American nheyo yeitsvo) yakaburitswa neNKF.

• Symptom

Early danho anogona kuva kushaya simba, giddy, dikita, kurwadziwa mudumbu, kuda kurutsa, kurutsa, anogona kuva dysspasm, tsandanyama, amaurosis, angina pectoris sezvo kurwara kufambira mberi, kuonekwa kuziva kurasikirwa kunyange, myocardial infarction, chikamu murwere haana chiratidzo.

• Occurrence Rate

Hypotension mu dialysis ndeimwe yematambudziko akajairika ehemodialysis, kunyanya kune vakwegura, chirwere cheshuga nevarwere vane chirwere chemoyo, uye chiitiko che hypotension mune yakajairwa dialysis inodarika 20%.

• Endanger

1. Vabatwa nechirwere chedialysis, vamwe varwere vakamanikidzwa kubuda pamushini pachine nguva, zvichikanganisa kukwana uye nguva dzose yehemodialysis.
2. Kukanganisa hupenyu hwebasa remukati fistula, hypotension yenguva refu ichawedzera kuitika kwemukati fistula thrombosis, zvichiita kuti kukundikana kwearteriovenous internal fistula.
3. Kuwedzera kwengozi yekufa.Zvidzidzo zvinoratidza kuti 2-gore kufa kwehuwandu hwevarwere vane nguva zhinji IDH yakakwirira se30.7%.

Sei uchigadzira kuderera kweropa mu dialysis

• Capacity dependent factor

1. Yakawandisa ultrafiltration kana kukurumidza ultrafiltration
2. Kuverenga kusina kururama kwehuremu hwakaoma kana kukundikana kuverenga uremu hwakaoma hwemurwere nenguva
3. Kusakwana dialysis nguva pavhiki
4. Sodium concentration ye dialysate yakaderera

• Vasoconstrictor dysfunction

1. Kupisa kwe dialysate kwakanyanya
2. Tora mushonga weBP usati waita dialysis
3. Kudya pa dialysis
4. Kupererwa neropa kuri pakati nepakati
5. Endogenous vasodilators
6. Autonomic neuropathy

• Hypocardiac basa

1. Kukanganiswa kwemoyo kuchengetedza
2. Arrhythmia
3. Cardiac ischemia
4.Pericardial effusion
5.Myocardial infarction

• Zvimwe zvinhu

1. Kubuda ropa
2. The hemolysis
3. Sepsis
4. Dialyzer reaction

Nzira yekudzivirira nekurapa dialysis yakaderera blood pressure

• Inodzivirira huwandu hweropa hunoshanda kubva pakuderera

Kudzora zvine musoro kwe ultrafiltration, kuongororwazve kwechinangwa chevarwere (yakaoma) uremu, kuwedzera kwevhiki nevhiki dialysis nguva, uchishandisa linear, gradient sodium curve mode dialysis.

• Kudzivirira uye kurapwa kwekuwedzera kusina kunaka kwemidziyo yeropa

Deredza tembiricha ye dialysate antihypertensive zvinodhaka kuderedza kana kumisa mushonga kudzivirira kudya panguva yedialysis gadzirisa anemia zvine musoro kushandiswa kweautonomic nerve function drug.

• Gadzirisa kubuda kwemoyo

Active kurapwa kwemoyo organic chirwere, nekuchenjerera kushandiswa kwemoyo kune zvinodhaka zvisina kunaka.