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Fluid overload with low Bp



Is there anyone encounter the case of fluid overload with low Bp

SBP 106 DBP 50 ,patient is not on any anti hypertensive

That is her starting HD BP , during dialysis BP fluctuating between 140 / 60 to 110/ 50

I encounter that every day. The extra fluid is not always in the vascular space, which may account for the low B/P.

Thank you for your reply ,

I heard mild creeps on auscultation on her lower lung ,but how can I remove the extra fluid with low BP

Sorry , creps

Chisca, RN

Specializes in Dialysis. Has 37 years experience.

Only every other treatment. Other than that it's not a problem.


Specializes in critical care.

Tells the creeps to lower their voices so you can hear better.


Specializes in Cath/EP lab, CCU, Cardiac stepdown. Has 3 years experience.

Midodrine and dialysis as tolerated is what I see.


Specializes in Peritoneal Dialysis, QA. Has 38 years experience.

Think of LVF any time you have extra volume with low B/p. Many times as you remove volume B/p increases. This is true for all pts not just dialysis pts. Also we can do sequencial dialysis and remove Fluid without removing electrolytes. When you move fluid from the tissues, and lungs the B/p should recover


Albumin and midodrine help most of the time, some just don't want to give it up tho


Look at the medications for too much BP meds- Most patients will tolerate dialysis better if they withold BP meds pre dialysis. Also send them for ECHO or EKG they may have heart failure. Some do better with Midodrine

Also pain meds can lower BP