Pre-dialysis assessment part 5

BLOOD PRESSURE

Ideally <140/80mmHg. Acceptable up to 160 systolic and 90 diastolic. Higher systolic may be acceptable in patients with a wide pulse pressure and where rapid falls occurs with dialysis.

• If blood pressure has been gradually increasing then consider whether dry weight reduction is required
• If blood pressure persistently > 160/90mmHg then obtain some interdialytic recordings for review by consultant. Ensure up to date information on antihypertensive medications and doses
• If blood pressure is markedly lower than previous pre-dyalisis recordings consider whether  patient is unwell; e.g. sepsis, dehydration

PULSE

Ideal pulse rate is 60-100 bpm and should be comparable with previous pre-dialysing recordings

• Feel rhythm manually to check pulse is regular in addition to machine recording
• Outside of this range consider dehydration, sepsis, cardiac arrhytmia