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Low blood pressure during dialysis increases risk of clots, according to Stanford-led study
Date:7/29/2011

STANFORD, Calif. A sudden drop in blood pressure while undergoing dialysis has long vexed many kidney patients. Side effects associated with this situation over the long term range from stroke to seizure to heart damage to death. Patients also suffer in the short term with gastrointestinal, muscular and neurologic symptoms.

Now one more disturbing side effect can be been added to this list.

A study led by researchers at the Stanford University School of Medicine reports an increased risk of blood clotting at the point where the patient's blood vessels are connected to the dialysis machine known as the point of vascular access. Researchers from the University of Utah also contributed to the study, which is to be published online July 29 in the Journal of the American Society of Nephrology.

"Our analysis shows another adverse consequence associated with a fall in blood pressure during dialysis for patients," said Tara Chang, MD, a Stanford nephrologist and lead author of the study. "Vascular access is their lifeline. It's required for dialysis and without dialysis, they'll die."

Dialysis is a life-extending procedure that, for most patients with kidney failure, involves sitting in a chair three or more times a week connected to an artificial kidney machine. Blood is cleansed by exchanging fluid and electrolytes across a membrane during each three- to four-hour session. Patients are attached to the dialysis machine through several means.

This point of vascular access is known as the "Achilles' heel" of patients on dialysis.

One of the most common forms of vascular access is a fistula, which is created surgically from the patient's own blood vessels. The tubes used to take blood to and from the body to the dialysis machine are connected to the body at this access point.

Clotting is one of the primary complications of an access point and can lead to its closure.

"These access points don'
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Contact: Michelle Brandt
mbrandt@stanford.edu
650-723-0272
Stanford University Medical Center
Source:Eurekalert

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