Why can some people have 20 liters of fluid and, you know, the short breath, but they generally can tolerate it, and the dialysis patients get into trouble so fast?

And the answer is that steep part of the diastolic fluid curve.

The last thing we want to see is people's blood pressure is 170s, 180s all night, because that person has a high risk of going into flash pulmonary edema,

and that's kind of a terrible outcome that's preventable, makes the nephrology team feel bad,

everyone feel bad because the patient came in and saying, hey, I should get my dialysis.

And we've said, oh, you wait until tomorrow, and they flash and get intubated or bi-pape, terrible outcome.

And that can be

partly mitigated by blood pressure control. That was Dr. John Danzinger and a phrologist at Beth Israel Deaconess Medical Center. Welcome to the Core I.M. Thigh Pearls podcast, bringing you high yield evidence-based pearls. I'm Dr. Shreda Chravetti and I'm joined by. Hi, I'm Dr. Nathan Kudlapur, internal medicine resident at Bethesial Deaconess Medical Center.

Today, we're continuing themes from the last episode, digging specifically into nuances

of blood pressure management and end-stage kidding disease, aka ESKD, patients on human dialysis.

Yes, I love this episode.

I got so much out of thinking deeply about blood pressure

and in all honesty,

wish I had this teaching so many years ago.

I know, such an important topic.

So let's delve into it.

We'll start by running through the pearls.

As always, test yourself after each of the following pearls.

Remember, the more you test yourself, the deeper your learning gains.

Pearl 1.

Blood pressure targets.

What numbers are we typically aiming for in patients on dialysis?

...