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Acetate-Free Biofiltration Reduces Intradialytic Hypotension: A European Multicenter Randomized Controlled Trial.
MedLine Citation:
PMID:  23406818     Owner:  NLM     Status:  Publisher    
Background: Intradialytic hypotension (IH) is a common complication of bicarbonate hemodialysis (BD) and contributes to the intolerance of dialysis and the high cardiovascular morbidity and mortality among dialysis patients, the risk of which can be contained by convective therapies. Aims/Methods: To assess whether acetate-free biofiltration (AFB), a hemodiafiltration technique found to improve intradialytic cardiovascular stability in short-term studies, can influence long-term IH rates, predialysis systolic blood pressure (SBP), cardiovascular morbidity and mortality by comparison with BD, we analyzed data from a randomized controlled trial enrolling 371 new-to-dialysis patients, 194 on BD and 177 on AFB. Results: During a 3-year follow-up, AFB carried a significantly lower risk of IH (incidence rate ratio 0.60 (95% CI 0.53-0.68), p < 0.0001). SBP dropped on AFB (p = 0.01), while it did not change on BD. Cardiovascular morbidity and mortality were similar between AFB and BD. Conclusion: AFB carries a lower long-term IH rate and reduces SBP by comparison with BD.
Nicola Tessitore; Antonio Santoro; Giovanni Oliviero Panzetta; Volker Wizemann; Rafael Perez-Garcia; Jorge Martinez Ara; Bruno Perrone; William Mantovani; Albino Poli
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-12
Journal Detail:
Title:  Blood purification     Volume:  34     ISSN:  1421-9735     ISO Abbreviation:  Blood Purif.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8402040     Medline TA:  Blood Purif     Country:  -    
Other Details:
Languages:  ENG     Pagination:  354-363     Citation Subset:  -    
Copyright Information:
Copyright © 2013 S. Karger AG, Basel.
Division of Nephrology, Azienda Ospedaliera Universitaria Integrata-Verona, Verona, Italy.
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