The Relationship between Hypoalbuminemia and Intradialytic Hypotension in Haemodialysis Patients

Manohar Lal Prasad; Prajit mazumdar; Aakanksha Malhotra; Malyaban das

Volume : IX, Issue : V, May - 2020

The Relationship between Hypoalbuminemia and Intradialytic Hypotension in Haemodialysis Patients

Manohar Lal Prasad, Prajit Mazumdar, Aakanksha Malhotra, Malyaban Das

Abstract :

Introduction: Intradialytic hypotension(IDH) is one of the most important acute complication occuring during routine hemodialysis treatment. Hypotension is a risk factor for mortality and morbidity in HMD patients. Materials and methods: This study was done in the department of medicine of Rajendra Institute of Medical Sciences(RIMS) on patients with CKD who received regular hemodialysis session at RIMS. The patients were selected in 2 groups according to presence of IDH– Group (I) included 30 patients who had IDH and Group (II) included 30 patients who did not have IDH. Mean age in both groups and male–female percentage , serum albumin, serum sodium , haemoglobin levels, Qb (Blood flow during hmd), surface area of dialyzer were compared in patients of both the groups Results: In our study, there was significant relation between hypoalbunemia and IDH (p–0.001). Majority of patients (70%) with IDH had low serum albumin. Hypoalbuminemia is a major risk factor of hypotension during HMD. Hypoalbuminemia causes IDH because of low osmolality leading to decreased oncotic pressure .This lead to decreased plasma refill and causes premature drop in BP leading to IDH . We also found a highly significant positive correlation between serum albumin and IVCD. Serum albumin is a strong predictor of intra–vascular volume status, thus explaining the correlation between serum albumin and of Inferior vena cava diameter( IVCD). Conclusion: We concluded that low serum albumin is a parameter which is associated with intradialytic hypotension. Also we found that bed side measurement of IVCD is a easy and efficient marker for prediction of intradialytic hypotension because of its positive relation with hypoalbuminemia. Hence, we recommend routine measurement of IVCD in all patients of CKD on routine USG along with kidney size and CMD so as to determine patients at risk of IDH