Document Detail


Blood volume monitoring to adjust dry weight in hypertensive pediatric hemodialysis patients.
MedLine Citation:
PMID:  18781335     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this study was to adjust dry weight by short-term blood volume monitoring (BVM)-guided ultrafiltration and evaluate the effects of optimizing dry weight on blood pressure (BP) control and intradialytic symptoms (IDS) in a group of hypertensive hemodialysis (HD) patients. The study was performed in four sequential phases, each of which lasted for 1 week, on nine hypertensive HD patients (six girls, age 16.9 +/- 3.1 years). In phase I, patients were observed by BVM. In phase II, BVM was used to guide ultrafiltration to adjust dry weight. Antihypertensive drugs were gradually tapered or withheld in phase III, when the patients were hypotensive and/or their IDS increased. In phase IV, this particular weight was maintained without any intervention. Pre- and post-HD body weight, pre-HD, post-HD, 30 min after HD casual BP values, and IDS in each HD session were recorded. The BP was also assessed by 44-h ambulatory BP monitoring (ABPM), which is an ideal method to determine BP changes throughout the interdialytic period at the beginning of phase I and at the end of phase IV. There was a decrease in mean dry weight, all casual systolic BPs, and systolic/diastolic ABPM at the end of the study (all p < or = 0.05). Antihypertensive drugs were stopped in five patients and reduced in two during phase III of the study. The IDS was more frequent (36%) in phase IV than in phase I (16%); however, this increase did not reach statistical significance. The results of this study suggest that short-term BVM guided-ultrafiltration may be a useful tool to diagnose volume overload and to adjust dry weight and, consequently, to achieve a better control of BP in pediatric HD patients.
Authors:
Cengiz Candan; Lale Sever; Mahmut Civilibal; Salim Caliskan; Nil Arisoy
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-09-10
Journal Detail:
Title:  Pediatric nephrology (Berlin, Germany)     Volume:  24     ISSN:  0931-041X     ISO Abbreviation:  Pediatr. Nephrol.     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-02-03     Completed Date:  2009-06-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8708728     Medline TA:  Pediatr Nephrol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  581-7     Citation Subset:  IM    
Affiliation:
Department of Pediatric Nephrology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey. cengizcandan@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Blood Pressure Monitoring, Ambulatory
Blood Volume / physiology*
Body Weight*
Child
Female
Humans
Hypertension / physiopathology*
Male
Monitoring, Physiologic*
Renal Dialysis*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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