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Intradialytic hypotension

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https://www.readbyqxmd.com/read/28337715/is-incremental-hemodialysis-ready-to-return-on-the-scene-from-empiricism-to-kinetic-modelling
#1
REVIEW
Carlo Basile, Francesco Gaetano Casino, Kamyar Kalantar-Zadeh
Most people who make the transition to maintenance dialysis therapy are treated with a fixed dose thrice-weekly hemodialysis regimen without considering their residual kidney function (RKF). The RKF provides effective and naturally continuous clearance of both small and middle molecules, plays a major role in metabolic homeostasis, nutritional status, and cardiovascular health, and aids in fluid management. The RKF is associated with better patient survival and greater health-related quality of life, although these effects may be confounded by patient comorbidities...
March 23, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28318624/treatment-tolerance-and-patient-reported-outcomes-favor-online-hemodiafiltration-compared-to-high-flux-hemodialysis-in-the-elderly
#2
Marion Morena, Audrey Jaussent, Lotfi Chalabi, Hélène Leray-Moragues, Leila Chenine, Alain Debure, Damien Thibaudin, Lynda Azzouz, Laure Patrier, Francois Maurice, Philippe Nicoud, Claude Durand, Bruno Seigneuric, Anne-Marie Dupuy, Marie-Christine Picot, Jean-Paul Cristol, Bernard Canaud
Large cohort studies suggest that high convective volumes associated with online hemodiafiltration may reduce the risk of mortality/morbidity compared to optimal high-flux hemodialysis. By contrast, intradialytic tolerance is not well studied. The aim of the FRENCHIE (French Convective versus Hemodialysis in Elderly) study was to compare high-flux hemodialysis and online hemodiafiltration in terms of intradialytic tolerance. In this prospective, open-label randomized controlled trial, 381 elderly chronic hemodialysis patients (over age 65) were randomly assigned in a one-to-one ratio to either high-flux hemodialysis or online hemodiafiltration...
March 15, 2017: Kidney International
https://www.readbyqxmd.com/read/28296033/predictors-of-post-hospitalization-recovery-of-renal-function-among-patients-with-acute-kidney-injury-requiring-dialysis
#3
Russell Pajewski, Patrick Gipson, Michael Heung
INTRODUCTION: Acute kidney injury (AKI) requiring dialysis complicates 1% of all hospital admissions, and up to 30% of survivors will still require dialysis at hospital discharge. There is a paucity of data to describe the postdischarge outcomes or to guide evidence-based dialysis management of this vulnerable population. METHODS: Single-center, retrospective analysis of 100 consecutive patients with AKI who survived to hospital discharge and required outpatient dialysis...
March 13, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28270412/relationship-between-hypotension-and-cerebral-ischemia-during-hemodialysis
#4
Clare MacEwen, Sheera Sutherland, Jonathan Daly, Christopher Pugh, Lionel Tarassenko
The relationship between BP and downstream ischemia during hemodialysis has not been characterized. We studied the dynamic relationship between BP, real-time symptoms, and cerebral oxygenation during hemodialysis, using continuous BP and cerebral oxygenation measurements prospectively gathered from 635 real-world hemodialysis sessions in 58 prevalent patients. We examined the relationship between BP and cerebral ischemia (relative drop in cerebral saturation >15%) and explored the lower limit of cerebral autoregulation at patient and population levels...
March 7, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28264150/blood-pressure-management-in-hemodialysis-patients-what-we-know-and-what-questions-remain
#5
REVIEW
Dana C Miskulin, Daniel E Weiner
Despite having thousands of blood pressure (BP) readings on individual dialysis patients over the course of a year, our knowledge about the optimal assessment of BP, the mechanisms underlying hypertension and its management remain incomplete. Observational studies reveal that BP is lower at home than when measured in the dialysis unit. However, we do not know if using home vs. in-center measurements to guide treatment decisions improves BP control and/or clinical outcomes. Moreover, a recent US study suggests that typical hemodialysis patients are unlikely to adhere to home monitoring over the long term...
March 6, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28185407/effects-of-sodium-concentration-and-dialysate-temperature-changes-on-blood-pressure-in-hemodialysis-patients-a-randomized-triple-blind-crossover-clinical-trial
#6
Hossein Ebrahimi, Mahboobeh Safavi, Marzieh Hossein Saeidi, Mohammad Hassan Emamian
The present study investigated the effects of different temperatures and sodium dialysate concentration on blood pressure in hemodialysis patients. Following Williams' design, hemodialysis patients were randomly assigned into four dialysis modes. Dialysate temperature was set at 37°C for modes A and C and, 35°C for modes B and D. Sodium concentration was set at 138 mmol/L in modes A and B, while it changed from 150 mmol/L to 138 mmol/L in modes C and D. Using analysis of variance for repeated measures, the mean values of systolic and diastolic blood pressure were investigated...
February 10, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28134403/-hfr-aequilibrium-can-be-an-answer-to-malnutrition-and-hypotension-in-dialisys-case-report
#7
Isabella Corino, Paolo Ria, Nicoletta Pertica, Gianluigi Zaza, Antonio Lupo
The interdialytic hypotension is still the most frequent complication during the hemodialysis. A-HFR has dynamic profiles of ultrafiltration and conductivity of the dialysate that ensure a better refilling and reduce compliance during the dialysis treatment, furthermore reduce the amino acid loss and has a lower inflammatory effect. In our Center, we wanted to analyze the impact of this kind of dialysis on intradialytic tolerance and nutritional status in two malnourished patients with encouraging data on the use of AHFR in malnutrition and disequilibrium syndromes...
November 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28120381/use-of-ultrasound-by-registered-nurses-a-systematic-literature-review
#8
REVIEW
Ulrich Steinwandel, Nicholas P Gibson, James Charles Rippey, Amanda Towell, Johan Rosman
BACKGROUND: In Western Australia (WA), most stable patients undergoing haemodialysis receive treatment in a satellite setting where no doctors are on-site during treatment hours, so nurses must make critical decisions about fluid removal. Some patients regularly experience adverse events during dialysis (intradialytic), often due to excessive ultrafiltration goals, with intradialytic hypotension being particularly challenging. Ultrasound of the inferior vena cava has been previously demonstrated being a rapid and non-invasive method for volume assessment on haemodialysis patients, thus could hold valuable information for the treating nurse...
January 25, 2017: Journal of Renal Care
https://www.readbyqxmd.com/read/28098098/a-study-of-clinical-assessment-of-frailty-in-patients-on-maintenance-hemodialysis-supported-by-cashless-government-scheme
#9
Manjusha Yadla, Jyothi Priyadarshini John, Mahesh Mummadi
This is a prospective cohort study to assess the prevalence of frailty in patients undergoing maintenance hemodialysis (HD) under the government-funded scheme at our center and to assess the relationship between frailty and falls, hospitalizations, and mortality. This was done at our center which is completely supported by the government, which provides HD to all the patients under poverty line. Epidemiological data, anthropometric measurements, comorbidities assessment, frailty assessment using Fried criteria, subsequent hospitalizations, falls, and mortality were recorded in our prevalent dialysis population at our center between October 2014 and October 2015...
January 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28024931/a-randomized-single-blind-crossover-trial-of-recovery-time-in-high-flux-hemodialysis-and-hemodiafiltration
#10
James R Smith, Norica Zimmer, Elizabeth Bell, Bernard G Francq, Alex McConnachie, Robert Mactier
BACKGROUND: The choice between hemodiafiltration (HDF) or high-flux hemodialysis (HD) to treat end-stage kidney disease remains a matter of debate. The duration of recovery time after treatment has been associated with mortality, affects quality of life, and may therefore be important in informing patient choice. We aimed to establish whether recovery time is influenced by treatment with HDF or HD. STUDY DESIGN: Randomized patient-blinded crossover trial. SETTINGS & PARTICIPANTS: 100 patients with end-stage kidney disease were enrolled from 2 satellite dialysis units in Glasgow, United Kingdom...
December 23, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27951544/haemodiafiltration-at-higher-volumes-and-patient-survival
#11
Francesco Locatelli, Lucia Del Vecchio, Vincenzo La Milia
Patient morbidity and mortality rates are still very high in standard low-flux haemodialysis (lf-HD). On-line haemodiafiltration (OL-HDF) is considered the most efficient dialysis technique, as clearances of small solutes, like urea, may be even higher than in lf-HD and clearances of middle solutes, like β2-microglobulin, are much higher than in lf-HD. OL-HDF has been suggested to reduce mortality compared to HD, possibly due to more effective removal of larger uraemic retention solutes and/or better fluid removal...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27915344/intractable-intradialytic-hypotension-with-ischemic-retinopathy
#12
Il Sang Shin, Soo Jeong Choi, Bo Yeon Kim, Jin Kuk Kim, Seung Duk Hwang, Sun Young Jang
No abstract text is available yet for this article.
2017: Blood Purification
https://www.readbyqxmd.com/read/27833921/management-of-patient-care-in-hemodialysis-while-focusing-on-cardiovascular-disease-events-and-the-atypical-role-of-hyper-and-or-hypotension-a-systematic-review
#13
REVIEW
Amjad Khan, Amer Hayat Khan, Azreen Syazril Adnan, Syed Azhar Syed Sulaiman, Siew Hua Gan, Irfanullah Khan
Background. Hemodialysis related hemodynamic instability is a major but an underestimated issue. Moreover, cardiovascular events are the leading cause of morbidity and mortality associated with blood pressure in hemodialysis patients. However, there have been many controversies regarding the role and management of hyper- and/or hypotension during hemodialysis that needs to be addressed. Objective. To critically review the available published data on the atypical role of hyper- and/or hypotension in cardiovascular associated morbidity and mortality in patients on hemodialysis and to understand the discrepancies in this context...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27773426/peritoneal-or-hemodialysis-for-the-frail-elderly-patient-the-choice-of-2-evils
#14
REVIEW
Edwina A Brown, Frederic O Finkelstein, Osasuyi U Iyasere, Alan S Kliger
Management of older people on dialysis requires focus on the wider aspects of aging as well as dialysis. Almost all frail and older patients receiving dialysis will default to in-center hemodialysis, although the availability of assisted peritoneal dialysis enables dialysis at home. As with any disease management decision, patients approaching end-stage renal disease need all the appropriate facts about their prognosis, the natural history of their disease without dialysis, and the resulting outcomes and complications of the different dialysis modalities...
February 2017: Kidney International
https://www.readbyqxmd.com/read/27772642/intensive-hemodialysis-and-treatment-complications-and%C3%A2-tolerability
#15
Jose A Morfin, Richard J Fluck, Eric D Weinhandl, Sheru Kansal, Peter A McCullough, Paul Komenda
Hemodialysis (HD) treatment can be difficult to tolerate. Common complications are intradialytic hypotension (IDH) and long time to recovery after an HD session. IDH, as defined by nadir systolic blood pressure < 90mmHg and intradialytic decline > 30mmHg, occurs in almost 8% of HD sessions. IDH may be caused by aggressive ultrafiltration in response to interdialytic weight gain, can lead to myocardial stunning and cardiac arrhythmias, and is associated with increased risk for death. Long recovery time after a treatment session is also common...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27761981/dialysate-bicarbonate-variation-in-maintenance-hemodiafiltration-patients-impact-on-serum-bicarbonate-intradialytic-hypotension-and-interdialytic-weight-gain
#16
Márcio Viegas, Cristina Cândido, Joana Felgueiras, José Clemente, Sara Barros, Rostislav Farbota, Filipa Vera, Antero Matos, Francisco Sousa
Introduction The dialysate bicarbonate (DB) influences the acid-base balance in dialysis patients. Very low and high serum bicarbonate (SB) have been related with a higher mortality. Acid-base balance also has been associated with hemodynamic effects in these patients. The trial aim was to compare the effect of DB concentration variation on SB levels in maintenance hemodiafiltration (HDF) patients and the effect on intradialytic hypotension and interdialytic weight gain. Methods  A prospective study, with 9 months of follow-up, involving 93 patients, divided in two groups: group 1 and group 2 with a DB of 34 mmol/L and 30 mmol/L, respectively, with monitoring of pre and post HDF SB, intradialytic hypotension, and interdialytic weight gain...
October 20, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27754086/os-19-09-bioelectrical-impedance-phase-angle-as-intradialytic-hypotension-predictor
#17
Vaidas Vicka, Laurynas Rimsevicius, Alvita Gincaite, Diana Sukackiene, Marius Miglinas
OBJECTIVE: Water balance and blood pressure (BP) alterations are strongly associated in haemodialysis (HD) patients. Aim of this study was to determine whether bioelectrical impedance analysis (BIA) parameters can be used as predictors of intradialytic hypotension (IDH). DESIGN AND METHOD: We conducted an observational study of chronic HD patients. BIA was measured before the HD procedure using InBody S10 (Biospace, Seoul, Korea) body composition analyzer. Intracellular water (ICW), extracellular water (ECW), total body water (TBW), ECW/TBW ratio and phase angle (PhA) were selected as markers of hydration state and thus possible predictors of IDH...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27643011/os-19-09-bioelectrical-impedance-phase-angle-as-intradialytic-hypotension-predictor
#18
Vaidas Vicka, Laurynas Rimsevicius, Alvita Gincaite, Diana Sukackiene, Marius Miglinas
OBJECTIVE: Water balance and blood pressure (BP) alterations are strongly associated in haemodialysis (HD) patients. Aim of this study was to determine whether bioelectrical impedance analysis (BIA) parameters can be used as predictors of intradialytic hypotension (IDH). DESIGN AND METHOD: We conducted an observational study of chronic HD patients. BIA was measured before the HD procedure using InBody S10 (Biospace, Seoul, Korea) body composition analyzer. Intracellular water (ICW), extracellular water (ECW), total body water (TBW), ECW/TBW ratio and phase angle (PhA) were selected as markers of hydration state and thus possible predictors of IDH...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27642391/-intradialytic-arterial-hypotension-in-a-patient-on-chronic-hemodialysis-revealing-ante-hypophyseal-insufficiency
#19
Jaouad El Maghraoui, Hanane Ouahabi, Nadia Kabbali, Mohamed Arrayhani, Farida Ajdi, Tariq Sqalli Houssaini
No abstract text is available yet for this article.
2016: Pan African Medical Journal
https://www.readbyqxmd.com/read/27615278/a-meta-analysis-of-sodium-profiling-techniques-and-the-impact-on-intradialytic-hypotension
#20
Nina Dunne
Introduction Hemodialysis has improved in recent years, however, despite such improvements, intra-dialytic hypotensive episodes still persist which can lead to a reduction in the overall effectiveness of the treatment. Profiling sodium levels during dialysis can improve vascular refilling and therefore may prevent hypotensive events. A number of profiling methods exist and this meta-analysis set out to examine the effectiveness of these methods. Methods To assess the effectiveness of hemodialysis sodium profiling techniques...
September 12, 2016: Hemodialysis International
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