Role of Nitric Oxide in intradialytic hypotension in HCV positive hemodialysis patients

Abstract

ABSTRACT Background: Intradialytic hypotension (IDH) is one of the most frequent hazards of haemodialysis, complicating about 20%–30% of all hemodialysis sessions. It is associated with increased cardiovascular morbidity and mortality. This is especially important in chronic liver patients, where determining the appropriate fluid balance is often challenging. Fluid overload is common and is linked to cardiovascular complications. By contrast, excessive fluid removal can lead to myocardial stunning, reversible progressive myocardial dysfunction and brain insult due to ischemic injury. So, the liver is vulnerable to hypervolemia, hypovolemia and endotoxemia, all of which are common in hemodialysis patients. Should IDH occurs in hepatic patients, it will limit the amount of ultrafiltration and result in sustained or worsening ascites. Objective: To evaluate the role of nitric oxide in intradialytic hypotension in HCV positive hemodialysis patients.