Post Date December, 02 2023
Heart failure is a serious complication of chronic renal failure. The main cause of heart failure in hemodialysis patients is excessive blood volume due to retention of water and sodium in the body. In addition, hypertension, severe anemia, electrolyte and acid-base balance disorder, inadequate dialysis, myocardial or coronary artery disease, and excessive blood shunt caused by arteriovenous fistula can aggravate heart failure.
Clinical manifestations of heart failure
1. Chest tightness, suffocation, difficulty breathing, forced to take upright breathing or semi seated position, unable to lie flat.
2. Irritability, high blood pressure, and significantly faster heart rate.
3. Significant weight gain during hemodialysis with shortness of breath.
4. Obvious facial and limb edema, anuria, oliguria, and dyspnea.
If any of the above symptoms occur, they should be promptly reported to the doctor and nurse, and the outpatient should immediately return to the hospital.
How to prevent heart failure
To prevent the occurrence of heart failure, it is necessary to take comprehensive measures through multiple approaches.
Strictly control water and salt intake, and avoid eating foods and fruits and vegetables with high water content.
2. Control weight. Hemodialysis patients should develop the habit of weighing themselves daily. Weight gain during dialysis should not exceed 3% to 5%. Hemodialysis should be performed as instructed by the doctor, and the hemodialysis time cannot be automatically changed. If necessary, the number of dialysis times can be increased, and if conditions permit, regular hemofiltration and perfusion can be selected.
3. Protect the heart. Avoid emotional excitement and heavy physical labor, exercise moderately, and promptly handle if the internal fistula expands too much (it should cause high cardiac output, accelerate the heartbeat, and increase the burden on the heart).
4. Actively correct anemia, regularly test blood routine to understand whether there is anemia and its extent, and under the guidance of a doctor, use erythropoietin, iron supplements, folic acid, etc. to correct anemia.
5. Measure blood pressure. Self measure blood pressure three times a day in the morning, middle, and evening, and keep records. If there are changes, promptly contact a doctor. For patients with hypertension, in addition to taking antihypertensive drugs as instructed by the doctor, emphasis should also be placed on a low salt diet.
