Evidence-Based Strategies for the Prevention and Management of Intradialytic Hypotension in Maintenance Hemodialysis Patients

Objective: To summarize evidence on the prevention and management of intradialytic hypotension in maintenance hemodialysis patients, providing reference for clinical practice. Method: Chinese and English databases, guideline websites, and professional society websites were systematically searched for literature on intradialytic hypotension guidance, including clinical decisions, guidelines, evidence summaries, systematic reviews, and expert consensuses, from database inception to October 1, 2024. Evidence was extracted after literature quality evaluation. Results: A total of 11 publications were included: 2 clinical decisions, 7 guidelines, 1 systematic review, and 1 expert consensus. 38 pieces of evidence were summarized across 4 themes: pre-dialysis assessment and prevention, monitoring and management during dialysis, medication use, and patient self-management. Conclusion: The best evidence for prevention and management of intradialytic hypotension in maintenance hemodialysis patients is scientific and comprehensive. Healthcare professionals are advised to apply this evidence judiciously in conjunction with clinical realities to ensure patient safety.