New research indicates that a sudden drop in blood pressure while undergoing dialysis can lead to an increased risk of blood clots in patients.
According to the study led by researchers at the Stanford University School of Medicine, the blood clot risk increases at the point where the patient's blood vessels are connected to the dialysis machine known as the point of vascular access.
"Our analysis shows another adverse consequence associated with a fall in blood pressure during dialysis for patients," said Tara Chang, MD, a Stanford nephrologist and lead author of the study.
"Vascular access is their lifeline. It's required for dialysis and without dialysis, they'll die," Chang added.
Dialysis is a life-extending procedure that, for most patients with kidney failure, involves sitting in a chair three or more times a week connected to an artificial kidney machine. Blood is cleansed by exchanging fluid and electrolytes across a membrane during each three- to four-hour session. Patients are attached to the dialysis machine through several means.
This point of vascular access is known as the "Achilles' heel" of patients on dialysis.
One of the most common forms of vascular access is a fistula, which is created surgically from the patient's own blood vessels. The tubes used to take blood to and from the body to the dialysis machine are connected to the body at this access point.
Clotting is one of the primary complications of an access point and can lead to its closure.
"These access points don't last forever," said Chang, a postdoctoral scholar.
"Many patients go through multiple access points moving from the right to left arm, or into the legs if necessary after repeated failures in the arms. When a patient runs out of access points, it becomes an emergency situation. Anything you can do to extend the life of the access point is important," added Chang.
The study has been published in the Journal of the American Society of Nephrology.