LAS ALTERACIONES HEMODINÁMICAS EN PACIENTES CON ENFERMEDAD RENAL CRÓNICA TERMINAL SOMETIDOS A HEMODIÁLISIS: Hemodynamic Alterations in Patients with End-Stage Chronic Kidney Disease Undergoing Hemodialysis

José Antonio Rosas Alegre; José Alberto Príncipe Pompa; Santos Moisés Ramírez Chavarry

doi:10.57188/ricsa.2025.034

Authors

José Antonio Rosas Alegre Escuela Profesional de Medicina Humana, Universidad Nacional del Santa, Ancash, Perú. https://orcid.org/0009-0008-1233-4258 (unauthenticated)
José Alberto Príncipe Pompa Escuela Profesional de Medicina Humana, Universidad Nacional del Santa, Ancash, Perú. https://orcid.org/0009-0000-5937-3221 (unauthenticated)
Santos Moisés Ramírez Chavarry Escuela Profesional de Medicina Humana, Universidad Nacional del Santa, Ancash, Perú. https://orcid.org/0009-0004-6367-7200 (unauthenticated)

DOI:

https://doi.org/10.57188/ricsa.2025.034

Keywords:

End-Stage Renal Disease; Hemodialysis; Hypotension; Hemodynamics; Cardiovascular Diseases

Abstract

End-stage chronic kidney disease causes significant alterations in the cardiovascular system, particularly in patients undergoing hemodialysis. Although this procedure is essential for removing toxins and regulating body fluid volume, it induces important hemodynamic changes that affect blood pressure and cardiac output. The most common complication is intradialytic hypotension, which may occur in multiple sessions and lead to dizziness, hypoperfusion of vital organs, and progressive clinical deterioration. This review aimed to describe the main hemodynamic changes associated with hemodialysis, explain the underlying pathophysiological mechanisms, and analyze the factors that compromise stability during treatment. It also examined interventions that may improve patient tolerance, including gradual adjustment of dry weight, the use of cooler dialysate solutions, nutritional assessment, and—in selected cases—techniques such as hemodiafiltration. Individualizing therapy according to each patient’s condition can reduce risks and optimize quality of life.

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Hemodynamic Alterations in Patients with End-Stage Chronic Kidney Disease UndergoingHemodialysis