How much BP is good enough to start dialysis?

Question

Hi doctor,

My father is a heart patient with amyloidosis and edema. He is in coma after cardiac arrest for seven days now. He was diagnosed with hypertension 26 years ago. His current medications are Lasix, Midodrine, Amiodarone and Eliquis. Patient also has AFib. Patient has BP readings of 121/71 mmHg. There is an option for dialysis, but could affect the fragile heart. How much does dialysis lower the pressure? Is dialysis being done in the stomach safer? What medication would help the patient before the procedure?

Answer 1

Hi,

Welcome to icliniq.com.

Blood pressure of 120/70 mmHg is good enough for dialysis to start. You can go with SLED (sustained low-efficiency dialysis) in which the chances of blood pressure dropping is very low.

Premedications which would help to prevent will be inotropes.

If you could help me by telling why dialysis is advised then I can help further. Is it because of fluid overload? Or increasing creatinine and BUN (blood urea and nitrogen)?

Revert back with the answers to a nephrologist online.

Answer 2

Hi,

Welcome back to icliniq.com.

Stomach dialysis or peritoneal dialysis is generally used in people who wants to take dialysis at home and for long period of time. That is not the case here.

There is a general rule in nephrology as heart is the king. So, hemodialysis (HD) can help by taking out fluid which would reduce stress on hearts and lungs.

My advice would be go for SLED for a few sessions and see how things are and then decide regarding the further course of action.

For further information consult a nephrologist online.