A Study of Intradialytic Complications in Chronic Kidney Disease Patients

Introduction: Chronic kidney disease (CKD) is a significant public health issue worldwide, with the need for renal replacement therapy at advanced stages. Hemodialysis is a life-sustaining treatment; however, several intradialytic complications occur during the treatment. The complications may impact the safety and comfort of the patient and the adequacy of the treatment. The present study aimed to determine the incidence and pattern of intradialytic complications and to evaluate clinical factors associated with their occurrence among chronic kidney disease patients undergoing hemodialysis. Materials and methods: An observational cross-sectional study was conducted at a tertiary care hospital in Vijayapura, Karnataka, India, from June 2024 to December 2025. A total of 90 CKD patients undergoing maintenance hemodialysis were included, and 205 hemodialysis sessions were prospectively observed. Intradialytic complications were identified using standard clinical definitions. Blood pressure and clinical parameters were recorded pre-dialysis, at hourly intervals during dialysis, and immediately post-dialysis. Data were analyzed using IBM SPSS Statistics, version 26 (IBM Corp., Armonk, NY, USA) and presented as mean ± standard deviation or frequency and percentage. Results: A total of 205 hemodialysis sessions were analyzed, of which 68 (33.2%) were complicated. Intradialytic hypotension was the most frequent complication, occurring in 42 (20.4%) sessions. Intradialytic hypertension occurred in 16 (23.5%) complicated sessions. Sessions complicated by hypotension were associated with higher ultrafiltration goal, higher ultrafiltration rate, higher pre-dialysis systolic blood pressure, and greater interdialytic weight gain compared with non-hypotensive sessions. Conclusion: Intradialytic complications occurred in a considerable proportion of hemodialysis sessions, with hypotension being the most common event. Higher ultrafiltration rates and greater interdialytic weight gain were associated with hypotensive episodes. Careful monitoring of hemodynamic parameters and optimization of fluid removal strategies are essential to improve patient safety during hemodialysis.