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BioMed Research International
Volume 2015, Article ID 724147, 7 pages
http://dx.doi.org/10.1155/2015/724147
Review Article

Intradialytic Hypotension and Cardiac Remodeling: A Vicious Cycle

1Renal Division, Department of Internal Medicine, National Taiwan University Hospital, Jin-Shan Branch, 51 Nan-Shih, Jin-Shan District, New Taipei City 208, Taiwan
2Graduate Institute of Toxicology, National Taiwan University Medical School, Section 1, 1 Jen-Ai Road, Zhong-Zheng District, Taipei 100, Taiwan
3Renal Division, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Zhong-Zheng District, Taipei 100, Taiwan
4Department of Geriatrics and Gerontology, National Taiwan University Hospital, 7 Chung-Shan South Road, Zhong-Zheng District, Taipei 100, Taiwan

Received 24 April 2014; Accepted 19 September 2014

Academic Editor: John J. Gildea

Copyright © 2015 Chia-Ter Chao et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Hemodynamic instability during hemodialysis is a common but often underestimated issue in the nephrologist practice. Intradialytic hypotension, namely, a decrease of systolic or mean blood pressure to a certain level, prohibits the safe and smooth achievement of ultrafiltration and solute removal goal in chronic dialysis patients. Studies have elucidated the potential mechanisms involved in the development of Intradialytic hypotension, including excessive ultrafiltration and loss of compensatory mechanisms for blood pressure maintenance. Cardiac remodeling could also be one important piece of the puzzle. In this review, we intend to discuss the role of cardiac remodeling, including left ventricular hypertrophy, in the development of Intradialytic hypotension. In addition, we will also provide evidence that a bidirectional relationship might exist between Intradialytic hypotension and left ventricular hypertrophy in chronic dialysis patients. A more complete understanding of the complex interactions in between could assist the readers in formulating potential solutions for the reduction of both phenomena.