Dialysis and Blood Pressure

Potentially, I am having a problem that is rarely associated with patients in my age group on dialysis: low blood pressure.

First, according to a Google search, low blood pressure is considered to be below 90/60. The morning of 1/7/2024, the chart below depicts my readings using my Fresenius-supplied Beurer pressure monitor, which I have been using since it was provided in August of 2023. All readings were taken on my bare left arm above the elbow.

My last reading, 93/56, is probably within the device’s accuracy. Other than being slightly dizzy when bending over, I don’t feel out-of-sorts. I contacted my dialysis nurse for guidance and received the following: “You need to refrain from using 2.5% solution until BP stabilizes. Hydrate…..” I have used a 2.5 % solution as a daily mixture. On one day, I use one 1.5% bag and two 2.5% bags; on the next, I flip it to two 1.5% bags and one 2.5% bag.

I do take three BP meds per day along with dialysis. For completeness in this blog, below is included input from Poe on the relationship of low blood pressure to dialysis. (Poe also generated the lead graphic.)

Yes, peritoneal dialysis can potentially lead to low blood pressure, although it is not a common occurrence. Peritoneal dialysis is a method used to remove waste products and excess fluid from the body in individuals with kidney failure. It involves using the peritoneal membrane, which lines the abdominal cavity, as a natural filter.

During peritoneal dialysis, a special solution called dialysate is introduced into the abdominal cavity, which absorbs waste products and excess fluid from the blood vessels surrounding the peritoneal membrane. This process helps to maintain the body’s electrolyte and fluid balance.

However, in some cases, the removal of fluid during peritoneal dialysis can decrease blood volume, which can result in low blood pressure, known as hypotension. Hypotension may cause lightheadedness, dizziness, weakness, or even fainting.

Several factors can contribute to low blood pressure during peritoneal dialysis, including rapid removal of fluid, inadequate fluid replacement, or individual patient characteristics. It is important for healthcare providers to closely monitor blood pressure levels during dialysis sessions and adjust the dialysate volume and composition accordingly to maintain stable blood pressure.

If a person experiences low blood pressure during peritoneal dialysis, healthcare professionals can take several measures to manage the situation. These may include adjusting the dwell time (the period during which the dialysate remains in the abdominal cavity), altering the dialysate concentration, or providing additional fluids to maintain blood pressure within an acceptable range.

If an individual on peritoneal dialysis experiences persistent or severe low blood pressure episodes, it is crucial to inform their healthcare team promptly. This allows for a thorough evaluation and appropriate adjustments to the dialysis prescription to ensure the best possible outcomes.