Document Detail


The effect of profiled hemodialysis on intradialytic hemodynamics when a proper sodium balance is applied.
MedLine Citation:
PMID:  12169846     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Profiled hemodialysis (HD) has been claimed to ameliorate intradialytic complications such as hypotension. Frequently, these profiles are based on providing the patient with an accumulating sodium load. This increases the risk of interdialytic complications, such as hypertension and increased weight gain. The present study investigated the effect of profiled HD, without an accompanying sodium loading, on intradialytic hemodynamics in stable HD patients. METHODS: In eight stable HD patients a standard hemodialysis (S-HD) was compared to a decreasing Na(+)-profiled hemodialysis (Na-HD), and an ultrafiltration profiled hemodialysis (UF-HD). Care was taken to have the sodium balances similar during these sessions. The patients were monitored non-invasively during dialysis with respect to their cardiac performance by means of electrical impedance cardiography, their variation in blood volume by means of an on-line optical measurement, and their hydration state by means of body impedance analysis. RESULTS: Sodium balance and mean arterial sodium concentrations were similar in the three treatments. Intradialytic hemodynamics during UF-HD were similar to those of S-HD. However, Na-HD improved blood pressure preservation, remarkably without significant blood volume preservation, due to a better stroke volume preservation in the first hour of dialysis. CONCLUSION: Sodium-balanced, Na-profiled HD improves blood pressure preservation in stable HD patients without providing the patients with a sodium load. This effect is due to a better stroke volume preservation early in dialysis, without a significant reduction in blood volume decrease. UF-HD, as mono-therapy, has no beneficial effect on intradialytic hemodynamics in stable patients.
Authors:
B Straver; P M J M De Vries; A J M Donker; P M ter Wee
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Blood purification     Volume:  20     ISSN:  0253-5068     ISO Abbreviation:  Blood Purif.     Publication Date:  2002  
Date Detail:
Created Date:  2002-08-09     Completed Date:  2003-07-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8402040     Medline TA:  Blood Purif     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  364-9     Citation Subset:  IM    
Copyright Information:
Copyright 2002 S. Karger AG, Basel
Affiliation:
Department of Nephrology, Institute for Cardiovascular Research-VU (ICAR-VU), Vrije Universiteit Medical Center, Amsterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Pressure / drug effects
Blood Volume / drug effects
Cardiac Output / drug effects
Dialysis Solutions / standards
Female
Heart Rate / drug effects
Hemodynamics / drug effects*
Humans
Hypotension / prevention & control
Male
Middle Aged
Renal Dialysis / standards*
Sodium / pharmacology,  standards*
Stroke Volume / drug effects
Vascular Resistance / drug effects
Chemical
Reg. No./Substance:
0/Dialysis Solutions; 7440-23-5/Sodium

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


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