Blood pressure management in persons receiving thrice-weekly hemodialysis is a perennial challenge. Intradialytic blood pressure management is particularly vexing, given the need to provide adequate volume removal during short treatment periods while avoiding excessively high or low blood pressures and minimizing extreme blood pressure changes.1 Numerous physiologic perturbations affect blood pressure during hemodialysis. Intravascular volume removal and refilling, cardiac contractility, dialysate temperature, and dialysate osmolality and composition have all received much attention, yet the effects of the medications regularly administered during hemodialysis are also potentially important.