What is a cause of hypotension during and after dialysis treatment?

• A. Infection
• B. Dialysis membrane reaction
• C. Removing too much fluid
• D. Drug side effects

Answer: (C)

During dialysis, removing too much fluid is the most common reason for hypotension. Ultrafiltration pulls water from the blood faster than the body's vascular refill can supply it from the interstitial space. When circulating volume drops, venous return to the heart falls, cardiac output decreases, and blood pressure falls. Reaching an appropriate dry weight and moderating the ultrafiltration rate helps keep BP stable. If hypotension occurs, clinicians slow or pause ultrafiltration, give saline, or adjust dialysate parameters to improve vascular refilling. Other factors like infection, dialyzer reactions, or drug effects can cause low blood pressure as well, but the direct, typical mechanism during and after dialysis is excessive fluid removal.