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High-performance hemodiafiltration and blood pressure stability
T Takenaka1, Y Tsuchiya, H Suzuki
1Tsuchiya Clinic, Tokyo, Japan.
Nephron
|January 1, 1997
Summary
Plasma nonrefilling rate impacts blood pressure during hemodialysis (HD). High flux hemodiafiltration (HDF) did not affect this, but high sodium dialysate reduced nonrefilling and blood pressure drops in HD patients.
Area of Science:
- Nephrology
- Cardiovascular Physiology
Background:
- Plasma nonrefilling is crucial for maintaining blood volume and pressure during dialysis.
- Blood pressure instability is a common complication of hemodialysis (HD).
Purpose of the Study:
- To estimate plasma nonrefilling rate.
- To assess the relationship between plasma nonrefilling and blood pressure stability during different dialysis modalities.
- To evaluate the impact of dialysate sodium concentration on plasma nonrefilling and blood pressure.
Main Methods:
- Standard hemodialysis (HD) with varying dialysate sodium concentrations.
- High-flux hemodiafiltration (HDF).
- Measurement of plasma nonrefilling rate and blood pressure changes.
Main Results:
- Higher plasma nonrefilling rates correlated with greater blood pressure decreases in standard HD.
- High-flux HDF did not significantly alter plasma refilling or blood pressure stability compared to standard HD.
- Restricting high sodium dialysate reduced plasma nonrefilling and blood pressure drops without increasing interdialytic weight gain.
Conclusions:
- High-performance HDF appears relatively safe regarding plasma refilling and blood pressure.
- Judicious use of high sodium dialysate may benefit HD patients experiencing hypotensive episodes.