• Stop or slow the rate of ultrafiltration
  • Place the patient in Trendelenburg position
  • Decrease blood-flow rate
  • Check patency of vascular access
  • Consider: occult sepsis, cardiac tamponade, ischemic bowel, bleeding, ischemic heart disease
  • Correct: anemia
  • Dialysate prescription
    • Na+: > 140 mEq/L (or sodium modeling)
    • Avoid low Ca2+
    • Cool temperature
  • Avoidance of food
  • Midodrine (2.5 mg/tab) 2.5mg in 30min before HD with 2.5mg titration upward
  • Sertraline (Zoloft 50mg/tab) 50-100 mg/d