Intradialytic hypotension:Prevalence, defintions, impact on quality of life

Intradialytic hypotension (IDH) is an important complication of the dialysis treatment that affects the Quality of Life (QOL) due to a high symptom burden. The major aims of this thesis are to get a better insight in the prevalence of IDH and the factors associated with this condition and to contribute in finding a definition that captures the most relevant aspects of IDH.IDH defined according to the EBPG guideline occurred in 6.7% of dialysis sessions. A systematic review of the current literature revealed that IDH occurred in 10.9% of dialysis sessions. These prevalences are much lower than the 20 to 30% of dialysis sessions that are generally reported in review articles. A higher interdialytic weight gain, diabetes, lower body height and weight and female gender were identified as risk factors for the occurrence of IDH. A significant association between QOL and parameters related to fluid restriction and between QOL and a patient-reported symptom score, indicating that the way patients experience the hemodialysis treatment is of influence on their QOL. The definition of IDH should be based on the purpose for which the definition is used. A personalized approach can support the patient in an individualized dietary advice and fluid restriction. Patient-reported symptom scores can help to understand the patient burden of the dialysis treatment and improve the quality of care. The nursing staff should be facilitated to give hemodialysis patients personal support