During intradialytic hypotension, which IV fluid is commonly used as part of the intervention?

• A. Dextrose solution
• B. Normal saline
• C. Lactated Ringer's solution
• D. No IV fluids

Answer: (B)

When a patient experiences intradialytic hypotension, the underlying issue is a drop in circulating volume from the fluid being removed during dialysis. The quickest and most reliable way to counter this is to rapidly expand the intravascular space with an isotonic IV fluid. Normal saline is 0.9% NaCl and provides water and sodium in the same osmolarity as blood, so it increases intravascular volume without shifting fluid into cells or altering osmolar balance. This helps raise blood pressure and improve organ perfusion promptly.

Dextrose solutions add sugar and don’t reliably increase intravascular volume; they can cause glucose fluctuations and other shifts that don’t address the drop in circulating volume. Lactated Ringer’s contains potassium and lactate, which can complicate electrolyte balance and are not ideal in patients with kidney failure. Giving no IV fluids would leave the hypotension untreated.