What is your approach to management of intradialytic hypotension and autonomic dysfunction in a patient with ESKD?

Decreasing dialysate temperature to 35.5 to 36 degrees has, in my experience, caused a marked decrease in intradialytic hypotension. We use midodrine in some instances. The decreased dialysate temperature is systemwide in all cases in our units.

I am going to only respond to the first part (intradialytic hypotension). This is a difficult problem. No great answer. The best option in my view is doing frequent extra dialysis treatments and isolated ultrafiltration. I am not in favor of high sodium baths as it may defeat the purpose by having p...

Since AD is positional, change the position to lying down. All other options increase supine hypertension, so avoid clonidine, etc.