Related Experiment Video
Updated: Jun 15, 2025

Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol
Published on: July 28, 2018
Effectiveness of blood volume change-guided ultrafiltration control (BV-UFC) in hemodialysis: a crossover comparative
Shintaro Hamada1, Masami Hata2, Shuntaro Furukawa2
1Department of Nephrology, Sanin Rosai Hospital.
Background And Hypothesis:
Intradialytic hypotension (IDH), a common hemodialysis (HD) complication, increases cardiovascular risks and affects prognosis. Rapid ultrafiltration (UF) is a key factor. The blood volume change-guided ultrafiltration control (BV-UFC) system, which adjusts UF rates based on real-time blood volume (BV) monitoring, aims to enhance hemodynamic stability and reduce IDH.
Methods:
A 6-week crossover trial compared BV-UFC and standard HD in reducing IDH. Patients underwent 2 weeks of each treatment. The primary outcome was the frequency of IDH episodes. Secondary outcomes were plasma refilling rate (PRR) and target UF volume achievement.
Results:
This study included 38 patients, with 31 patients completing the trial. The frequency of IDH episodes was significantly reduced in patients using the BV-UFC system (P = .019). HD sessions with BV-UFC system showed a significantly higher PRR throughout the treatment session, particularly during the first 0-1 h and 1-2 h of treatment (P = .019, P < .001, P < .001), as compared with standard HD and the target UF volume was consistently higher in the BV-UFC sessions (P < .01).
Conclusion:
The BV-UFC system effectively reduced the incidence of IDH by automatically adjusting the UF rate based on BV, without compromising treatment safety or UF volume. These findings suggest that BV-UFC can enhance hemodynamic stability and improve dialysis outcomes in patients undergoing HD (jRCT Study No. jRCT1062230034, registration date: 1 July 2023).
More Related Videos
Related Concept Videos
Glomerular Filtration Rate and its Regulation
GFR regulation involves two primary intrinsic controls: the myogenic and tubuloglomerular feedback mechanisms.
The myogenic...
Dialysis
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Heart Failure Drugs: Diuretics
Antihypertensive Drugs: Action of Diuretics
Hormonal Regulation of Blood Pressure
Epinephrine and Norepinephrine
The adrenal medulla releases epinephrine and norepinephrine, catecholamines that enhance and extend the sympathetic or "fight or flight" physiological response. These hormones escalate heart rate and the force of contraction...
Renal Failure: Dose Adjustments
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...

