Blood pressure on SDD txs

From what I’ve learned from talking with several patients who do SDD, blood pressure very much normalizes. They say they can be in the 90’s still pulling off fluid and not even feel any symptoms. How low do you allow your bp to go on SDD txs?

My BP did not normalize when I was on SDD over a 4 month period. It improved a bit, but I still had to stay on a BP med. It normalized totally within days of starting daily nocturnal, no meds, and this was consistent for the rest of the year and a half until I got my transplant.

The rule in our program here is that there’s a need to do something if pre-treatment BP is less than 120 (be extra vigilent during treatment, call for change in dry weight). If at any time BP drops below 110, infuse 200ml saline. If after doing this a second time, BP is still too low, discontinue treatment and call. One should not underestimate the risk of a hypotensive crash at home. Its not worth dying just to get a treatment in.

On short daily, BP is checked every 30 minutes, because the risk is greater due to larger volume removal. On nocturnal, you remove much less per hour, and so BP is way more stable. But if BP is much lower than 120 at the start, you know you may have some problems, and so with experience, you might remove less or if on daily, you might just do a short treament to normalize potassium (less experienced will call the nurse, of course). You know automatically that if your BP is lower than 120 pre-treatment, you have gradually gained real weight and you need to adjust your dry weight upwards accordingly.


Our protocol was if BP went below 100 infuse saline. However, there is beginning to be some controversy over BP. Our heart doctor an other heart doctors have told us they would like to see dad’s BP’s in the 90’s if he feels good. I think I just read an article the other day where they are saying it used to be normal BP of 120/80 but they are changing their mind on that and think it should be lower. I do agree with Pierre nocturnal does stablize the BP. My father used to get hypotensive on in-center treatments and once we started nocturnal that never happened again. Knock on wood.

Be aware that patients that still have their kidneys inside of them tend to have higher blood pressure those who had their kidneys completely removed…

In my case scenario I tend to have my blood pressure in the 80s/90s and before ever starting daily-short I had high blood pressure and was taking blood pressure meds…after 3 months on daily-short blood pressure meds were stopped…

The National Kidney Foundation has developed guidelines for chronic kidney disease called K/DOQI (Kidney Disease Outcomes Quality Initiative). These guidelines are based on a review of the medical literature and are developed by experts in kidney disease and the various conditions that the guidelines were developed for. The K/DOQI guideline for hypertension states that the target blood pressure should be less than 130/80 to reduce the risk of cardiovascular disease. For the target range, see Guideline 7. All the guidelines on hypertension and anti-hypertensive agents can be found at:

The National 7th Report of the Joint National Committee on the Prevention, Detection, and Treatment of High Blood Pressure (called JNC-7) has the same recommendation in its guidelines for the National High Blood Pressure Education Program:

If the doctors want his blood pressure to be in the 90s, you might want to be watchful for symptoms that his blood pressure is too low for him. Symptoms to watch for include lightheadedness, dizziness, fainting (all of which risk falls). Be especially watchful for chest pain which can occur with low blood pressure because that could lead to heart attack.

My b/p is slowly going up, but “normal” for me is 90/60. I don’t pay attention to numbers I pay attention to how I feel. If I get crampy or lightheaded, then I need saline, if I feel fine I don’t. Strangely b/p isn’t a good indicator for me, I have had to add saline at a fairly high b/p for me and not when it is significantly lower.


I have been having a low BP problem and it is being discussed on IHD: It has helped me maybe it can help you.