Low Blood pressure

[Mich1949]

Just out of interest, how low does your blood pressure go during dialysis?I am in a session now, and it went down to 74/ 41 a couple of hours ago. I felt really quite unwell.

Having been told off in the past for not calling a nurse, today I pressed my call button. Unfortunately, it wasn't properly plugged in... typical! For a few minutes, I felt quite scared.

I managed to catch the eye of a nurse, and asked him to pause the fluid removal for 15 minutes, turn the temperature of the machine down, and laid with my head below my feet.

With 29 mins left to go, I am now at 95/65, which is comfortable.

Does this sound familiar?

[Darlenia]

That's really low low blood pressure! I'm surprised you didn't pass out. You were very smart decision to call the staff - it's your wellbeing at stake. My hubby was hemodialysis and it never went that low. I, myself, have passed out from low blood pressure due to very low sodium levels; it can happen shockingly fast.

[Hidden]

Hi. My mom passed away several months ago. Dialysis was too much for her, but the last straw was her untreatable heart problems, which were painful. Anyway, she did have a problem with low blood pressure. I think in dialysis, when it went lowest, they would give her more fluids, I think. I am forgetting about that period alot now that she has passed. I hope all the best for you.

[cs65 NKF Ambassador]

That's very low. You did the right thing to alert the nurse. I'm surprised that the nurse didn't also give you saline solution. If this starts to happen a lot of times, the nephrologist can prescribe midodrine to elevate your blood pressure. In that case, the staff would have to monitor your blood pressure and give it to you as the nephrologist prescribes during your treatments. When I was on hemodialysis in center, my blood pressure cuff would activate regularly and the nurses could see it on their screens. I was on midodrine during some of my 4 years on dialysis.

[Mich1949 in reply to cs65]

I am on Midrodine, and take a stronger dose than I should. If it wasn't for the fact that I try to constantly monitor my blood pressure during dialysis, and take medication whenever I feel it is getting low, Goodness knows where I would be.On that day, I took 30 MLS of Midrodine during dialysis, which is the maximum daily dose.

[cs65 NKF Ambassador in reply to Mich1949]

Have you considered getting a referral to a cardiologist? I'm asking because I developed Takutsubo cardiomyopathy during a dialysis session around a year after I started dialysis. The nurses tested my blood and it appeared like it was a heart attack. I went immediately to the ER after getting off the machine and they retested me and ended up sending me by ambulance to a larger hospital with a great cardiac care unit. Once there, they did an echocardiogram and diagnosed the cardiomyopathy. It took a couple of days before I could swallow an aspirin (one symptom was being unable to swallow and having chest pain) and get a cardiac catheterization. That showed a 70% blockage in one coronary artery and smaller blockages in other ones. I was able to be treated medically with a daily low dose aspirin and a statin drug daily. I went to cardiac rehab and recovered completely, but it was pretty scary. I'm pretty sure your PCP could do an EKG and if necessary refer you to a cardiologist. Blood pressure is nothing to fool around with. I even fainted in the hospital that time the first time they let me get up to use the bathroom. I also have orthostatic hypotension (my blood pressure can suddenly drop if I stand up too quickly). Now I have a kidney transplant, but my blood pressure is still pretty low most mornings. Good luck to you!

[Mich1949 in reply to cs65]

Thanks for your reply. Sorry to hear of your problems. I too had a cardiomyopathy some four years ago ( pre dialysis; it was apparently due to a virus). Since then I have had an ablation to get rid of rogue heart beats, and a cardio version to get me back in sinus rhythm after then being in AF. Fortunately, all seems good and I have a fraction ejection if some 58% on the last test ( about a year ago).I have just received an appointment with the nephrologist in February; I'll grill him about these problems, also the fact that they keep telling me my blood flow test in dialysis is not good enough. When I see the vascular surgeon, he says "It's as good as it will ever be"..and sends me away. I keep being bounced back and forth between the two. Such a waste of time.

[cs65 NKF Ambassador in reply to Mich1949]

I know. Why can't specialists just talk to each other? It's a fact that dialysis can lead to heart problems, and it looks like you had them even before starting dialysis. Have you tried to enlist your PCP in coordinating care? We had an excellent one who was very involved in coordinating my care amongst all my specialists. If your nephrologist and your cardiologist are in the same hospital system it is easy for them to see your reports, labs and medical notes from visits in the electronic medical record. Even if they are not, you can still have one doctor fax the other. Heaven forbid they should actually call each other! You actually have to ask them to do that. It's exhausting sometimes, but we all have to be in charge of our own medical care. If I were you, I wouldn't wait until February. You can often get answers by using the email system in your Patient Portals.

[Mich1949 in reply to cs65]

You're right, I need to tackle this as soon as I can .

[horsie63]

mine dropped to 107/70 and so far that’s the lowest it’s been. T try he de cane around Thur a a nd said I should take my Coreg before so I did Sat and my BP stayed rather low for me. It seems like nothing but guesswork on their part. If u don’t take the cireg before it’s in the 140/90 range.

[carabet]

I too am on midodrine to raise my blood pressure during dialysis. I take 10mg about an hour before, then 5 mg midway through if needed. I definitely would recommend you ask your doctor about it. Good luck!

[Lanalassii]

I yell out to a nurse and ask for a bonus, they know what to do! Yes, it’s a horrible feeling!

Try to watch what you eat before going in, I found out I’m dehydrated so doc told me to stop taking my Lasix and dulcolax, as dialysis binds you up believe it or not or works the other way too! Soon they’ll get yours down Pat, just yell out if you have to… I don’t let them take fluid off me, hope this helps!

[Dialysis_Saves]

yes, you are bound to lower your blood pressure during dialysis as the excess fluids come out of your body. however it seems very low, so have a lower UF target during your session. You can also check your sodium levels which might be low, which can also cause this.

I have put out a post on the importance of sodium levels during dialysis here:

medium.com/12-years-and-cou...