Document Detail

Automatic feedback control of relative blood volume changes during hemodialysis improves blood pressure stability during and after dialysis.
MedLine Citation:
PMID:  16219059     Owner:  NLM     Status:  MEDLINE    
Automatic feedback systems have been designed to control relative blood volume changes during hemodialysis (HD) as hypovolemia plays a major role in the development of dialysis hypotension. Of these systems, one is based on the concept of blood volume tracking (BVT). BVT has been shown to improve intra-HD hemodynamic stability. We first questioned whether BVT also improves post-HD blood pressure stability in hypotension-prone patients and second, whether BVT is effective in reducing the post-HD weight as many hypotension-prone patients are overhydrated because of an inability to reach dry weight. After a 3-week period on standard HD, 12 hypotension-prone patients were treated with two consecutive BVT treatment protocols. During the first BVT period of 3 weeks, the post-HD target weight was kept identical compared with the standard HD period (BVT-constant weight; BVT-cw). During the second BVT period of 6 weeks, we gradually tried to lower the post-HD target weight (BVT-reduced weight; BVT-rw). In the last week of each period, we studied intra-HD and 24 hr post-HD blood pressure behavior by ambulatory blood pressure measurement (ABPM). Pre- and post-HD weight did not differ between standard HD and either BVT-cw or BVT-rw. Heart size on a standing pre-dialysis chest X-ray did not change significantly throughout the study. There were less episodes of dialysis hypotension during BVT compared with standard HD (both BVT periods: p<0.01). ABPM data were complete in 10 patients. During the first 16 hr post-HD, systolic blood pressure was significantly higher with BVT in comparison with standard HD (both BVT periods: p<0.05). The use of BVT in hypotension-prone patients is associated with higher systolic blood pressures for as long as 16 hr post-HD. BVT was not effective in reducing the post-HD target weight in this patient group.
Casper F M Franssen; Judith J Dasselaar; Paulina Sytsma; Johannes G M Burgerhof; Paul E de Jong; Roel M Huisman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hemodialysis international. International Symposium on Home Hemodialysis     Volume:  9     ISSN:  1492-7535     ISO Abbreviation:  Hemodial Int     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-10-12     Completed Date:  2005-12-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101093910     Medline TA:  Hemodial Int     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  383-92     Citation Subset:  IM    
Dialysis Center Groningen, Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands.
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MeSH Terms
Blood Pressure
Blood Volume*
Blood Volume Determination / methods
Diabetes Complications / complications,  physiopathology,  therapy
Hypotension / etiology,  physiopathology*
Kidney Failure, Chronic / complications,  physiopathology,  therapy
Middle Aged
Prospective Studies
Renal Dialysis* / adverse effects

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