Figure 62

The common treatments for hemodynamic instability of patients undergoing dialysis. It is important to begin by excluding reversible causes associated with hypotension because failure to recognize these abnormalities can be lethal. Perhaps the most common reason for hemodynamic instability is an inaccurate setting of the dry weight. Once these conditions have been dealt with, the use of a high sodium dialysate, sodium modeling, cool temperature dialysis, and perhaps the administration of midodrine may be attempted. All of these maneuvers are effective in stabilizing blood pressure in dialysis patients.

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