Question

Complications Associated with Hemodialysis Treatment

Please match the pathophysiology with the complication.

Cramping               Hypotension                    Restless legs                     Fatigue

Cardiopulmonary arrest             Pyrogen- or infection-induced fever

Itching                   Anaphylactic reactions

1. Air embolism: _______________________________________
   
2. Most prevalent symptom: Hypotension

3. Reduced muscle perfusion: _______________________________________

4. Vasodilation: _______________________________________

5. Electrolyte abnormalities: _______________________________________

6. Unknown etiology: _______________________________________

7. Reaction to dialysis membrane: _______________________________________

8. Contraction of intravascular volume: ___________________________________

9. Autonomic dysfunction: _______________________________________

10. Dialysis line disconnection: _______________________________________

11. Decreased plasma volume with slow refilling: ____________________________

12. Impaired vasoactive and cardiac responses: _____________________________

13. Systemic infection: _______________________________________

14. Unknown etiology: _______________________________________

15. Bacterial contamination of water system: _______________________________

Answer 1

1.Air embolism:cardiopulmonary arrest

2.Reduced muscle perfusion:cramping

3.Vasodilation:hypotension

Vasodilation is the widening of blood vessels.When blood vessels dilate, the flow of blood is increased due to a decrease in vascular resistance and increase in cardiac output. Therefore, dilation of arterial blood vessels (mainly the arterioles) decreases blood pressure.

4.Electrolytes imbalance:fatigue

Consider the example of sodium,

Low sodium, also called hyponatremia, causes water to move into cells. High sodium, or hypernatremia, causes fluid to move out of the cells. When either of these things happens in brain cells, it can cause personality changes, headache, confusion and FATIGUE.

5.Reaction to dialysis membrane:anaphylactic reactions

Reactions attributed to the hemodialyzer are generally divided into two types:

Type A - anaphylactoid reaction

Increased risk in patients with a history of atopy, high IgE levels, eosinophilia and allergic reactions during dialysis1

Type B - mild reaction