BMC Nephrology | |
Dialysate temperature adjustment as an effective treatment for baroreflex failure syndrome in hemodialysis patient | |
Takashi Yokoo2  Ichiro Ohkido2  Izumi Yamamoto2  Yudo Tanno2  Keitaro Yokoyama2  Koki Takane2  Natsumi Tanabe1  | |
[1] Jikei University Hospital, 3-25-8, Nishishimbashi, Minato-ku, Tokyo 105-0003, Japan;The Division of Nephrology and Hypertension, Jikei University School of Medicine, 3-25-8, Nishishimbashi, Minato-ku, Tokyo 105-0003, Japan | |
关键词: Hypertension; Hemodialysis; Baroreflex failure; | |
Others : 1082615 DOI : 10.1186/1471-2369-15-151 |
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received in 2014-04-26, accepted in 2014-09-10, 发布年份 2014 | |
【 摘 要 】
Background
Baroreflex failure syndrome is a rare disorder which causes labile blood pressure, headache, flushing, diaphoresis and emotional lability. It is caused by history of trauma or radiotherapy in the cervical legion, bilateral carotid-body tumor or resection of glossopharyngeal nerve. We experienced a case of hemodialysis patient who had difficulty in controlling blood pressure during dialysis because of his baroreflex failure syndrome and successfully controlled his blood pressure by adjusting dialysate temperature.
Case presentation
We report a case of a 68-year-old CKD5 patient who had difficulty in hemodialysis treatment because of severe fluctuations in blood pressure with hypertensive attacks and hypotensive episodes which caused him a severe discomfort. His dialysis treatment was started in 2010 and since that time baroreflex failure syndrome has been suspected because of his clinical manifestations and history of radiotherapy in the cervical region for his lingual cancer in 1994. Baroreflex failure syndrome is diagnosed by symptoms and cold stressor test. We performed a cold stressor test on an experimental baroreflex failure syndrome mouse and induced a significant elevation of blood pressure. From this experimental finding of model mouse, we changed the patients dialysate temperature between 34-38° according to his change in blood pressure though 80–240 mmHg. From this attempt, his blood pressure was successfully controlled between 100–180 mmHg and he was able to continue hemodialysis without any discomfort.
Conclusion
In our case, environmental stimulation such as temperature change modified the patients fluctuating blood pressure. Change of dialysate temperature could be an option for controlling the unstable blood pressure due to baroreflex failure syndrome.
【 授权许可】
2014 Tanabe et al.; licensee BioMed Central Ltd.
【 预 览 】
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