Volume Effects of Daily Hemodialysis

Daily hemodialysis appears to be well tolerated, with hypotension rarely complicating such therapy, a finding that is the subject of this review. When daily hemodialysis utilizes a shorter treatment time, this may limit the intradialytic reduction in plasma volume. This reduction is a function of treatment time, ultrafiltration rate (UFR), and plasma refilling rate (PRR). However, daily therapy may be associated with a higher UFR and lower PRR, both of which may accentuate the fall in plasma volume. The reduced frequency of intradialytic hypotension may, in part, be related to other aspects of such therapy, such as the smaller oscillations and decreased dialytic flux of hemodynamically active solutes.