Personalized prevention and treatment strategies for hypotension patients during maintenance hemodialysis

Hemodialysis (HD) is the most common renal replacement therapy for patients with end-stage renal disease. Intradialytic hypotension (IDH) is a serious complication during dialysis. It is mainly related to hypovolemia, resulting in premature interruption of dialysis, and insufficient clearance of fluid and solute, which eventually causes a variety of adverse clinical outcomes such as decline in quality of life, inadequate dialysis, vascular access embolism, loss of residual renal function, cardiovascular events and death, seriously threatening the life and health of patients. Despite its clinical significance, the early prediction of IDH remains a challenge. In recent years, the discovery of some new biomarkers and the use of volume assessment devices, hemodialysis equipment, biofeedback systems, new drugs and artificial intelligence early warning models have provided great help in the early identification and treatment of IDH. In view of the clinical heterogeneity of blood pressure changes in hemodialysis patients, it has become an inevitable trend to shift from standardized management to personalized nursing. This article mainly reviews the best strategies for personalized prevention and treatment of IDH.