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Hemodialysis hypotension

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https://www.readbyqxmd.com/read/29675862/hemodialysis-a-model-for-extreme-physiology-in-a-vulnerable-patient-population
#1
REVIEW
Jeroen P Kooman, Krassimir Katzarski, Frank M van der Sande, Karel M Leunissen, Peter Kotanko
Hemodialysis (HD) is a lifesaving treatment for patients with end-stage renal disease, which is very efficient in the correction of abnormalities of the internal environment. However, this efficiency also induces significant hemodynamic, thermal, and respiratory stressors. These have parallels with the extreme physiologic demands which are normally mainly experienced by healthy subjects under adverse environmental conditions, with the difference that they must be endured by a vulnerable patient population. Hemodynamic stress induced by ultrafiltration leads to a decline in circulating blood volume, which may result in intradialytic hypotension (IDH) and changes in tissue perfusion, which may have long-term consequences for the function of vital organs such as the brain and the heart...
April 19, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29669016/hemodynamic-response-to-fluid-removal-during-hemodialysis-categorization-of-causes-of-intradialytic-hypotension
#2
Nathan W Levin, Marcia H F G de Abreu, Lucas E Borges, Helcio A Tavares Filho, Rabia Sarwar, Surendra Gupta, Tahir Hafeez, Shaul Lev, Caroline Williams
Background: Intradialytic hypotension is a clinically significant problem, however, the hemodynamics that underlie ultrafiltration and consequent hypotensive episodes has not been studied comprehensively. Methods: Intradialytic cardiac output, cardiac power and peripheral resistance changes from pretreatment measurements were evaluated using a novel regional impedance cardiographic device (NICaS, NI Medical, Peta Tikva, Israel) in 263 hemodialysis sessions in 54 patients in dialysis units in the USA and Brazil with the goal of determining the various hemodynamic trends as blood pressure decreases...
April 14, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29657203/the-development-of-malnutrition-is-not-dependent-on-its-traditional-contributing-factors-in-patients-on-maintenance-hemodialysis-in-developing-countries
#3
Syed Rizwan Ali Bokhari, Mirza Ameer Faizan Ali, Syed Arsalan Khalid, Bushra Iftikhar, Hafiz Ijaz Ahmad, Ahlam Safdar Hussain, Usman Yaqoob
Malnutrition in dialysis population is associated with significant morbidity and mortality. Nutritional assessment is a neglected area in hemodialysis (HD) patients in developing countries. The aim of the study was to find out whether any traditional parameters have statistically significant correlation with malnutrition. All 58 end-stage renal disease patients on maintenance HD in our dialysis unit were enrolled in this cross-sectional study. The nutritional status was assessed by a predesigned questionnaire including subjective global assessment (SGA)...
March 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29624853/impact-of-salt-reduction-in-meals-consumed-during-hemodialysis-sessions-on-interdialytic-weight-gain-and-hemodynamic-stability
#4
Arthur Colson, Anita Brinkley, Philippe Braconnier, Nadia Ammor, Michel Burnier, Menno Pruijm
INTRODUCTION: Patients on hemodialysis (HD) are advised to limit daily water- and salt intake to reduce interdialytic weight gain (IDWG). To counterbalance protein-losses, protein-rich meals are sometimes provided during HD sessions, but their salt content is not always taken into account. The aim of this study was to assess the influence of a lower salt content of meals provided during HD sessions on IDWG, blood pressure (BP), and hemodynamic stability during dialysis. METHODS: This monocentric, interventional study was proposed to all the patients treated with three weekly HD sessions...
April 6, 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29594137/artificial-intelligence-for-the-artificial-kidney-pointers-to-the-future-of-a-personalized-hemodialysis-therapy
#5
REVIEW
Miguel Hueso, Alfredo Vellido, Nuria Montero, Carlo Barbieri, Rosa Ramos, Manuel Angoso, Josep Maria Cruzado, Anders Jonsson
Background: Current dialysis devices are not able to react when unexpected changes occur during dialysis treatment or to learn about experience for therapy personalization. Furthermore, great efforts are dedicated to develop miniaturized artificial kidneys to achieve a continuous and personalized dialysis therapy, in order to improve the patient's quality of life. These innovative dialysis devices will require a real-time monitoring of equipment alarms, dialysis parameters, and patient-related data to ensure patient safety and to allow instantaneous changes of the dialysis prescription for the assessment of their adequacy...
February 2018: Kidney Diseases
https://www.readbyqxmd.com/read/29593797/factors-influencing-p-terminal-force-in-lead-v1-of-the-ecg-in-hemodialysis-patients
#6
Andrzej Jaroszyński, Anna Jaroszyńska, Wojciech Dąbrowski, Tomasz Zaborowski, Andrzej Stepulak, Marek Iłżecki, Tomasz Zubilewicz
Introduction: Atrial fibrillation (AF) is a highly prevalent arrhythmia in hemodialysis (HD) patients, and an HD session may be a trigger for AF episodes. An abnormal P-terminal force in lead V1 (PTFV1) may predict new-onset AF in HD patients. The aim of the study was to assess the influence of the HD process on PTFV1 and to evaluate possible factors influencing PTFV1 in a group of selected HD patients. Material and methods: One hundred and fifty-three selected HD patients entered the study...
March 2018: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/29581966/impaired-gut-epithelial-tight-junction-expression-in-hemodialysis-patients-complicated-with-intradialytic-hypotension
#7
Tsai-Kun Wu, Paik-Seong Lim, Jong-Shiaw Jin, Ming-Ying Wu, Chang-Hsu Chen
Background: There is accumulating evidence pointing to uremia-induced impairment of the intestinal epithelial barrier structure in advanced chronic kidney disease (CKD) and hemodialysis (HD) patients. In this study, the impact of intradialytic hypotension on intestinal barrier integrity is being explored. Methods: Immunohistochemical staining was used to detect the expression of 4 types of tight junction (TJ) proteins such as occludin, zonula occludens-1 (ZO-1), claudin-1, and claudin-4, in colonic samples of a group of patients receiving segmental colectomy...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29528138/when-is-more-frequent-hemodialysis-beneficial
#8
Rita S Suri, Alan S Kliger
The use of frequent hemodialysis (HD) is growing, with the hope of improving outcomes in end-stage renal disease. We narratively review the three randomized trials, 15 comparative cohort studies, and several case series of frequent HD that empirically demonstrate the potential efficacy and adverse effects of these regimens. Taken together, the randomized studies suggest frequent HD may result in left ventricular mass regression. This effect is most pronounced when left ventricular mass is abnormal, but attenuated by significant residual urine output...
March 12, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29511057/hemodiafiltration-to-address-unmet-medical-needs-eskd-patients
#9
Bernard Canaud, Jörg Vienken, Stephen Ash, Richard A Ward
Hemodiafiltration combines diffusive and convective solute removal in a single therapy by ultrafiltering 20% or more of the blood volume processed using a high-flux hemodialyzer and maintaining fluid balance by infusing sterile nonpyrogenic replacement fluid directly into the patient's blood. In online hemodiafiltration, the large volumes of replacement fluid required are obtained by online filtration of standard dialysate through a series of bacteria- and endotoxin-retaining filters. Currently available systems for online hemodiafiltration are on the basis of conventional dialysis machines with added features to safely prepare and infuse replacement fluid and closely control fluid balance...
March 6, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29483138/mechanisms-clinical-implications-and-treatment-of-intradialytic-hypotension
#10
REVIEW
Patrick B Reeves, Finnian R Mc Causland
Individuals with ESKD requiring maintenance hemodialysis face a unique hemodynamic challenge, typically on a thrice-weekly basis. In an effort to achieve some degree of euvolemia, ultrafiltration goals often involve removal of the equivalent of an entire plasma volume. Maintenance of adequate end-organ perfusion in this setting is dependent on the institution of a variety of complex compensatory mechanisms. Unfortunately, secondary to a myriad of patient- and dialysis-related factors, this compensation often falls short and results in intradialytic hypotension...
February 26, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29479995/effect-of-acute-intradialytic-aerobic-and-resistance-exercise-on-one-day-blood-pressure-in-patients-undergoing-hemodialysis-a-pilot-study
#11
Joon-Sik Kim, Joo-Hark Yi, Jinho Shin, Yeon-Soo Kim, Sang-Woong Han
BACKGROUND: Hypertension and intradialytic hypotension are independent risk factors for mortality in hemodialysis patients. We hypothesized that intradialytic exercise would increase blood pressure (BP) during dialysis and decrease it during the postdialytic period. The present study aimed to investigate the effect of acute intradialytic exercise on BP both during dialysis and for 20 hours post-dialysis, and to detect any differences in effects of aerobic exercise (AE), resistance exercise (RE), and usual care (UC-the control condition)...
February 26, 2018: Journal of Sports Medicine and Physical Fitness
https://www.readbyqxmd.com/read/29477417/intradialytic-hypotension-related-episodes-identification-based-on-the-most-effective-features-of-photoplethysmography-signal
#12
Vahid Reza Nafisi, Mina Shahabi
BACKGROUND AND OBJECTIVE: One of the most adverse conditions facing the hemodialysis patient is repetitive hypotension during their dialysis session. Different factors can be used to monitor patient conditions and prevent Intradialytic Hypotension (IDH) during hemodialysis. These factors include blood pressure, blood volume, and electrical Impedance factors. In this paper, pre-IDH and IDH episodes were recognized and classified by using the features of the finger photoplethysmography (PPG) signal...
April 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29470006/oxygen-saturation-and-heart-rate-variations-as-predictors-of-intradialytic-hypotension
#13
Vincent King Yu Chan, Lawrence Wing Chi Chan, Daniel Hung Kay Chow
AIntradialytic hypotension (IDH) occurring during hemodialysis (HD) may cause severe complications and can be life-threatening. IDH is a common symptom in patients with end stage renal disease undergoing HD. Currently, no effective predictive models for IDH exist. This study analyzed data on variations in oxygen saturation (SaO2 ) and heart rate (HR) in 68 patients during their HD sessions by using sequence alignment and Boolean algebra. Three classifiers derived from SaO2 and HR variation data were developed as predictors for predetermining IDH occurrence within 30 minutes...
January 2018: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
https://www.readbyqxmd.com/read/29461016/postdialysis-recovery-time-is-extended-in-patients-with-greater-self-reported-depression-screening-questionnaire-scores
#14
Andrew Davenport, Ayman Guirguis, Michael Almond, Clara Day, Joseph Chilcot, Maria Da Silva Gane, Naomi Fineberg, Karin Friedl, Benjamin Spencer, David Wellsted, Ken Farrington
INTRODUCTION: Most patients take time to recover after a hemodialysis (HD) session. It has been suggested that recovery time is associated with intradialytic hypotension and rapid solute clearances. Other studies have reported a linkage to depression. We investigated the association between recovery time and intradialytic hypotension and depression. METHODS: In five UK HD units, we screened for depressive symptoms using the Beck depression inventory-II, Patient Health Questionnaire, and recorded sessional blood pressures and Kt/Vurea...
February 20, 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29455201/deterioration-of-hepatic-oxygenation-precedes-an-onset-of-intradialytic-hypotension-with-little-change-in-blood-volume-during-hemodialysis
#15
Sojiro Imai, Susumu Ookawara, Kiyonori Ito, Satoshi Kiryu, Kaoru Tabei, Yoshiyuki Morishita
No abstract text is available yet for this article.
February 16, 2018: Blood Purification
https://www.readbyqxmd.com/read/29452460/outcomes-after-surgical-pulmonary-embolectomy-for-acute-submassive-and-massive-pulmonary-embolism-a-single-center-experience
#16
Chetan Pasrija, Anthony Kronfli, Michael Rouse, Maxwell Raithel, Gregory J Bittle, Sheelagh Pousatis, Mehrdad Ghoreishi, James S Gammie, Bartley P Griffith, Pablo G Sanchez, Zachary N Kon
OBJECTIVES: Ideal treatment strategies for submassive and massive pulmonary embolism remain unclear. Recent reports of surgical pulmonary embolectomy have demonstrated improved outcomes, but surgical technique and postoperative outcomes continue to be refined. The aim of this study is to describe in-hospital survival and right ventricular function after surgical pulmonary embolectomy for submassive and massive pulmonary embolism with excessive predicted mortality (≥5%). METHODS: All patients undergoing surgical pulmonary embolectomy (2011-2015) were retrospectively reviewed...
March 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29437702/diagnosis-and-treatment-of-intradialytic-hypotension-in-maintenance-hemodialysis-patients
#17
Christopher W McIntyre, Fabio R Salerno
No abstract text is available yet for this article.
March 7, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29436152/immersion-enhanced-fluid-redistribution-can-prevent-intradialytic-hypotension-a-prospective-randomized-crossover-clinical-trial
#18
Keren Doenyas-Barak, Nedal Garra, Ilia Beberashvili, Shai Efrati
INTRODUCTION: Intradialytic hypotension (IDH) is an important cause of morbidity and mortality among hemodialysis patients. We used an immersion model to evaluate the role of reduced effective circulating volume, and to examine whether facilitated refilling can prevent IDH. METHODS: Ten male hemodialysis patients who had frequent episodes of IDH were randomized to a mid-week "wet" or "dry" hemodialysis session, and subsequently underwent the other session in a crossover manner...
February 13, 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29430730/cerebral-ischemia-during-hemodialysis-finding-the-signal-in-the-noise
#19
EDITORIAL
Clare MacEwen, Peter Watkinson, Lionel Tarassenko, Christopher Pugh
Hemodialysis patients have multiple risk factors for small vessel cerebrovascular disease and cognitive dysfunction. Hemodialysis itself may cause clinically significant neurological injury through repetitive cerebral ischemia. However, supporting evidence to date consists of epidemiological associations, expert opinion, and small, single-centre studies of variable methodological quality. Isolating the impact of intra-dialytic hemodynamic instability from underlying renal and vascular disease on clinically relevant functional outcomes would require very large, controlled studies, given the heterogeneity and confounding comorbidities of the population, and the complex relationship between blood pressure and cerebral oxygen delivery...
February 11, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29402775/intradialytic-hypotension-as-an-independent-risk-factor-for-long-term-mortality-in-maintaining-hemodialysis-patients-a-5-year-follow-up-cohort-study
#20
Jinbo Yu, Zhonghua Liu, Bo Shen, Jie Teng, Jianzhou Zou, Xiaoqiang Ding
AIMS: This study aimed to assess risk factors of intradialytic hypotension (IDH) and the association of prognosis and IDH among maintenance hemodialysis (MHD) patients. METHODS: Among 293 patients, 117 were identified with IDH (more than 4 hypotensive events during 3 months). The association between IDH and survival was evaluated. RESULTS: The incidence of IDH was 39.9%. Age, ultrafiltration rate, N-terminal pro-B-type natriuretic peptide (NT-proBNP), albumin, β2-microglobulin (β2MG), and aortic root inside diameter (AoRD) were independently associated with IDH...
February 2, 2018: Blood Purification
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