The Full form of IDH is Intradialytic Hypotension. It is defined as a decrease in systolic blood pressure by less than or equals to 20 mm Hg or a decrease in mean arterial pressure by 10 mm Hg, and is associated with symptoms that include yawning, sighing, abdominal discomfort, nausea, restlessness, vomiting, muscle cramps, dizziness or fainting, and anxiety. The incidence of a symptomatic reduction in blood pressure during (or immediately following) dialysis ranges from 15 to 50% of dialysis sessions. It is a major cause for morbidity in those with cardiovascular compromise and in elderly Hemodialysis patients. It impairs patient well-being, limits ultrafiltration, and increases the risk for cerebral and coronary ischemic events as well as vascular access thrombosis. This is a clinical diagnosis that relies on the review of the blood pressure values and the patient’s symptoms. Laboratory tests and imaging studies that might help identify causes as well as severity of intradialytic hypotension are as: EKG to exclude acute myocardial infarction or arrhythmias, especially if chest pain is present, Blood glucose to exclude hypoglycemia, Hemoglobin to exclude acute blood loss, Cardiac biomarkers (CK-MB, troponin T, troponin I) if chest pain or EKG abnormality is present, 24-hour Holter-monitor to exclude cardiac arrhythmias, or Serum cortisol to exclude adrenal insufficiency.
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