Less symptomatic hypotension using blood volume controlled ultrafiltration

Symptomatic hypotension due to ultrafiltration (UF) is one of the most frequent unwanted side effects of dialysis therapy. Using hemoglobinometry for continuous monitoring of blood volume (BV), ultrafiltration rate (UFR) can be adapted to actual changes in BV. A control system is shown in which UFR is set according to a predefined profile of BV. The conditions of control are: relative BV shall decrease steadily; BV shall decrease rapidly during the first 60 min of dialysis, thereafter decrease in BV should be less; UFR shall be as high as possible; and dry weight should be obtained within a given time. Application of this controlled UF method in 10 dialysis patients shows significantly fewer hypotensive periods and muscle cramps compared to conventionally constant UFR. It is concluded that BV controlled UF is an important step toward optimizing dialysis therapy.