Blood pressure goes done soon after I start dialysis, then shoots up as soon as I come off the machine. Can anyone help?

[shriranjan]

[mikeb]

I'm not a clinician but, from experience with my wife's home dialysis, I would say that its quite normal for blood pressure to drop after commencing dialysis and again there is normally an increase when the session finishes. How much it increases at the end of a session is determined by how much fluid is taken off. Taking off too little, will cause it to rise more. You don't say what your blood pressure is before, during and after your dialysis so it's difficult to be definitive about your issue but I would be looking critically at your dry weight and maybe reducing it in 0.5 kg max. steps, up to 1 kg per week, until your blood pressure is under control at the end of each session. Other than that you need to talk to a clinician who can advise if your medication needs changing.

[mickw]

It might be worth asking the nurses to use the different programs on the machine, so that it`s not taking to much off at first, the programs dialyse at a more calmer rate so it keeps your blood more under control, my blood pressure changed a bit like traffic lights (changing every five minutes) when i was on dialysis, then they started doing the different programs and i found it worked, i also would look at your fluid intake it might need a little ajustment (i know it`s hard to do), it might be worth having a chat to the consultant if they know of anything that might work, and chating to your dietician,

[DavidJW]

I am a home haemodialysis patient and have the same symptons as yourself; presume you are also on HHD otherwise this topic should be dicussed with the unit staff

This I think is quite usual and normal so long as you are not also having symptons of going "flat" simply explained by the fact that as you dialyse then a volume of blood is out of your body thereby reducing the pressure withinn yiour vascular system. After washback the body blood volume is returned to normal therefore the blood pressure also readjusts back up to normal.

If you are also tending to "go flat" or your blood pressure is far different to that which it should be then the volume and rate of removal both need to be looked at and advice taken from staff

[Hidden]

Hi, My husband has end stage 5 and although he's on CAPD rather than haemodialysis he has had extreme BP changes during treatment. His BP dropped so low that he appeared to be having a fit or a stroke. These happened on several occasions and were frightening to watch as each time it looked as if he was dying and I came to terms with losing him. Things shifted when during one of several A&E visits we were told that a drastic change in BP can occur when the vaso-vagal nerve is stimulated by the fluid entering or leaving the body. Might be worth enquiring about. We were glad to hear there is no threat to life and my husband is now able to control the pace of fluid entry and exit. Sue