Tips to reduce hypotension, please?

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Poppy
Posts: 2
Joined: Tue Jan 19, 2021 9:58 pm

Tips to reduce hypotension, please?

Post by Poppy »

Hi,
I’ve just joined and was hoping to get some practical advice. My elderly mum started haemodialysis a few months ago. After about 25 - 30 minutes on dialysis, she starts to feel hot, sweaty, shaky and nauseous. This leads to discomfort in her chest, palpitations, headache and vomiting. From what I’ve read, this is hypotension and from what I’ve read, she should drink more water before each session. Is this correct and does it really work? Also, is this the only thing that works or are there any other things she can do? Finally, will this stage pass after she’s been on dialysis for longer or is this part of haemodialysis? Thanks in advance 🤞
wagolynn
Posts: 1322
Joined: Thu May 23, 2013 2:49 pm

Re: Tips to reduce hypotension, please?

Post by wagolynn »

Hi Poppy,
I have seen this in other patients for the first few sessions but as their bodies adjusted to Dialysis the symptoms subsided.

Dialysis removes waste material out of the blood, and (if needed) removes excess fluid, with healthy kidneys this goes on all the time but on dialysis it is removed three times a week in 2 to 4 hrs, which of course, is quite a chemical shock to her system.
Not removing this waste is not an option.

The dialysis unit staff will have seen this before, and will make suggestions on the best way to combat the sickness but in general it usually gets better with time.

If Mum is not needing excess fluid taking off, then a drink before a session may help but if she has swollen ankles and feet, drinking before a session just means more fluid will have to be taken off.

Best wishes.
wagolynn
Posts: 1322
Joined: Thu May 23, 2013 2:49 pm

Re: Tips to reduce hypotension, please?

Post by wagolynn »

Hi,
How is Mum getting on now?

If she is still having problems, try asking her GP for anti sick medication.
A long while ago, before I was diagnosed with Meniere's disease, at times I got vertigo just standing up, I prescribed an anti sick pill to tucked under my upper lip when required, it was very effective, this sort of thing may help Mum.
I am afraid I do not remember the name, I think it may have been Buccastem.
Poppy
Posts: 2
Joined: Tue Jan 19, 2021 9:58 pm

Re: Tips to reduce hypotension, please?

Post by Poppy »

Hi wagolynn,

Thank you for responding. Yes, having 2-3 drinks before dialysis seems to be working. Hopefully, this will continue to work. However, I was wondering that if this is the solution, then maybe if the nurses didn’t take any (or took less) fluids off during dialysis, then maybe my mum wouldn’t need to have the 2-3 drinks beforehand? My mum still urinates as pre-dialysis and doesn’t have problems with fluid retention. Or do the nurses have to remove fluids as part of the dialysis process?
wagolynn
Posts: 1322
Joined: Thu May 23, 2013 2:49 pm

Re: Tips to reduce hypotension, please?

Post by wagolynn »

Hi,
Yes, you could try mentioning it to the staff.

Fluid removal -
The consultant usually makes an intelligent guess at a patients, 'Dry weight' (weight with no retained fluid).
Patients are weighed before dialysis (Wet weight) the Dry weight is subtracted from the wet weight, this figure is the retained fluid, usually 300mls is added to the, the 300mls represents fluid gained in the dialysis process.

There is a simple test you/Mum can do, just press on the flesh above the ankle (say 30secs) then let go, and look to see if the resultant hollow disappears quickly.
If not retaining water, the dimple (hollow or depressed area) will clear away almost immediately, you may get a red blush where you were pressing, but the skin will be back in place with no sign of a dimple.
If the dimple clears slowly then there is some fluid retention.
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