Intensive Care Medicine

, Volume 29, Issue 10, pp 1645–1649 | Cite as

Hypotension during intermittent hemodialysis: new insights into an old problem

  • Frédérique SchortgenEmail author
Physiological Note


The main indication for renal replacement therapy in critically ill patients is ischemic acute tubular necrosis associated with multiple organ failure requiring mechanical ventilation and catecholamine administration. The kind of renal replacement therapy offering the best hemodynamic tolerance remains debated. Intermittent hemodialysis (IHD) is often viewed by many ICU physicians as inducing hemodynamic instability. The application of recent concepts regarding hemodialysis modalities is able to solve part of this old problem [1]. A major problem with IHD is the direct application of chronic hemodialysis concepts in the management of acute renal failure. This approach is responsible for much of the observed hemodynamic instability and can be minimized by thoughtful planning prior to IHD in the critically ill patient.

What are the mechanisms of hypotension during hemodialysis?

In critically ill patients intradialytic hypotension results from the underlying process and is...


Renal Replacement Therapy Vasomotor Tone Fluid Removal Chronic Hemodialysis Patient Intradialytic Hypotension 
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Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  1. 1.Réanimation Médicale et InfectieuseHôpital Bichat-Claude BernardParisFrance

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