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A 46 year old man wth long-standing DM and ESRD is undergoing hemodialysis. He has completed his run of dialysis and you find him smewhat cnfused, wth a BP of 86/42. Which of the following factors most likely cntributed to the post dialysis hpotension?
A.Reduced temp of diasylate
B.concamitant use of aniti hypertensive therapy
C.Impaired autonomic response
D.Poor dietary intake during dialysis
E.hyperphosphatemia
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C ...seems auotonomic instability
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I think its E. Blood pressure is decreased due to ineffective renal function and phosphate is also increased due to this. But I am not sure.
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the objective of this question was to learn that there can be hpotension post-dialysis. All the above mentioned options can coz hypotension but teh most common is fluid deficit. In the above mentioned vignette the patient has a history of diabetes mellitus. This patient is most at risk of Diabetic neurpathy. In this patient cohort hypotension due to autonomic neuropathy is most common.
OTHERWISE THE MCC OF HYPOTENSION POST DIALYSIS IS FLUID IMBALANCE.
chill
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c ,autonomic neuropathy,IM q bank que
