Low Blood Pressure

[WillieWundt]

I have been having some problems with low blood pressure while on dialysis. I usually start off with normal BP of around 120/70. I have stopped taking all of my BP medication. No matter what I set as my UF rate (I usually remove between 1 and 2 K at an UF rate of .6 - .7) my BP drops to 100/50 within an hour of treatment. I also have a regular heartbeat when I am not dialyzing, but as soon as I begin treatment my heartbeat becomes irregular. I am beginning to think that it has something to do with either the dialysate temperature (it is set to 10 on the pure flow) or to the actual composition of the dialysate. Is there anyone else with a similar problem or can anyone suggest a remedy.

[PrimeTimer]

Hope your cardiologist or nephrologist figure this out for you and soon! Sometimes my husband's BP/pulse drops too low during treatment (for instance, a pulse of 48 is way too scary). When his pulse drops that low, we take him off the machine ASAP. Lately tho, I've learned to either slow down the UF removal rate or, what seems to be working better for him, we stop removing fluid (I adjust the UF rate down to 0.00) but continue to dialyze him for the full treatment time (providing he isn't feeling nauseated and his pulse is above 48). We are thinking the reason for these drops in BP/pulse might be because he is close to his dry weight and doesn't need much fluid removed. Sometimes when he weighs himself on the scale, it appears that he has gained a little weight but...we don't know if it's weight from eating or being constipated or fluid gain. I use to give him saline boluses and take him off the machine right away but then he wasn't getting enough dialysis. So, if he's close to his dry weight and his BP/pulse drop, I simply stop removing fluid and things go back to normal in a few minutes. By the way, I check his BP/pulse every 30 minutes during treatment and on the days when he starts out low, I check him even more frequently. He dialyzes 5 times a week. He usually only needs between 0.6 to 1.6 liters of fluid removed. Just to give you an example, if he needs 1.50 liters removed, I dialyze him for 3 hours, 30 minutes at a UF rate of 0.50 and dialysate rate of about 8.4 to 8.6 and he uses 30 liters with the Pureflow heater set at 15.       


-Sorry this was so long but wanted to make the point that you are not alone with this problem and that whatever is causing your BP/pulse to drop, it is probably something that can be fixed.

[cassandra]

I sometimes have periods of constantly low BP (80/40), but it is generally okay. Sometimes it's because my dry weight is too low, and I've been eating more than 'normal' , and sometimes it's a mystery.
I hope you get yours sorted soon.

Love, Cas

[justagirl2325]

My husband is the same.  He has low BP's very often and they come on quick.  He can be on dialyis and doing fine and all of a sudden he'll drop to 68/48 where I have to give saline to wake him up (I pretty much watch him like a hawk).  It's the rare occasion we see it coming and adjust the UF rate. 

When we do see it coming we try to fix it.  The only thing that works for him is pickles.  I'm not sure if this is a good thing to do or not.  He only dialysizes for four hours every second day and he usually needs 2.5 to 3.5 to be removed.  So he hates having to receive saline boluses and worries when we can't get enough off in one session that the next one will be brutal (higher amount to come off means wicked cramps).  So he'll eat like 4 reduced sodium pickles and his BP will go up immediately and stay there for the rest of the treatment.

[noahvale]

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[justagirl2325]

Yes, I do mean every other day.  His doc recommended 6 days a week, but he's not willing to do it that often.  I do try to encourage him but it's his choice.  He says he feels ok and his labs are good with every second day.  Perhaps he will do it more often in the winter months when it's dark at 5pm, freezing cold and not much else to do. 

Thanks for those, I will print those out for him.  It's not something that the home-hemo nurses ever think is a problem.  When we were there training there was a guy getting 7.0 L pulled every session (he was large but still...). 

[noahvale]

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