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Prolonged protective effect of short daily hemodialysis against dialysis-induced hypotension.
Kidney Blood Press Res. 2005; 28(2):68-76.KB

Abstract

BACKGROUND/AIMS

Short daily hemodialysis (HD) has a protective effect against dialysis-induced hypotension (DIH). We examined whether this effect extends beyond the treatment period.

METHODS

We analyzed clinical variables in 6 patients (5 with diabetes mellitus) who underwent conventional hemodialysis (CHD) for 4 h three times weekly for 12 weeks; then short daily HD for 2 h six times weekly for 12 weeks, and then 12 more weeks of CHD. All patients had been given vasopressors for severe DIH.

RESULTS

The severe DIH disappeared during the short daily HD. There were significant decreases in body weight (BW), cardiothoracic ratio (CTR), blood pressure (BP), normal saline solution (NSS) amount (62.8 +/- 26.4 vs. 9.8 +/- 7.4 ml/session, p < 0.05), frequency (0.60 +/- 0.26 vs. 0.10 +/- 0.07 infusions/session, p < 0.05) and postdialysis atrial natriuretic peptide (ANP) (176.8 +/- 56.4 vs. 104.8 +/- 42.3 pg/ml, p < 0.05). Weekly ultrafiltration volume (6.3 +/- 0.9 vs. 7.9 +/- 0.7 l, p < 0.05) was significantly higher during the short daily HD period than during the first CHD period. The vasopressor treatment was therefore stopped or reduced in all patients during the short daily HD period. Because DIH recurred in the second CHD period despite a significant increase in BP, the vasopressor treatment was resumed in 5 patients. BW, CTR, NSS infusion amount and frequency, or postdialysis ANP did not differ significantly between the short daily HD and second CHD periods.

CONCLUSIONS

The protective effect of short daily HD against DIH lasted more than 12 weeks after the treatment ended. We therefore conclude that temporary short daily HD is useful for preventing DIH.

Authors+Show Affiliations

Division of Nephrology and Endocrinology, Department of Medicine, Nihon University School of Medicine,Tokyo, Japan. kokada@med.nihoniu.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

15677874

Citation

Okada, Kazuyoshi, et al. "Prolonged Protective Effect of Short Daily Hemodialysis Against Dialysis-induced Hypotension." Kidney & Blood Pressure Research, vol. 28, no. 2, 2005, pp. 68-76.
Okada K, Abe M, Hagi C, et al. Prolonged protective effect of short daily hemodialysis against dialysis-induced hypotension. Kidney Blood Press Res. 2005;28(2):68-76.
Okada, K., Abe, M., Hagi, C., Maruyama, T., Maruyama, N., Ito, K., Higuchi, T., Matsumoto, K., & Takahashi, S. (2005). Prolonged protective effect of short daily hemodialysis against dialysis-induced hypotension. Kidney & Blood Pressure Research, 28(2), 68-76.
Okada K, et al. Prolonged Protective Effect of Short Daily Hemodialysis Against Dialysis-induced Hypotension. Kidney Blood Press Res. 2005;28(2):68-76. PubMed PMID: 15677874.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prolonged protective effect of short daily hemodialysis against dialysis-induced hypotension. AU - Okada,Kazuyoshi, AU - Abe,Masanori, AU - Hagi,Chihiro, AU - Maruyama,Takashi, AU - Maruyama,Noriaki, AU - Ito,Ken, AU - Higuchi,Terumi, AU - Matsumoto,Koichi, AU - Takahashi,Susumu, Y1 - 2005/01/25/ PY - 2004/11/01/accepted PY - 2005/1/29/pubmed PY - 2005/7/26/medline PY - 2005/1/29/entrez SP - 68 EP - 76 JF - Kidney & blood pressure research JO - Kidney Blood Press Res VL - 28 IS - 2 N2 - BACKGROUND/AIMS: Short daily hemodialysis (HD) has a protective effect against dialysis-induced hypotension (DIH). We examined whether this effect extends beyond the treatment period. METHODS: We analyzed clinical variables in 6 patients (5 with diabetes mellitus) who underwent conventional hemodialysis (CHD) for 4 h three times weekly for 12 weeks; then short daily HD for 2 h six times weekly for 12 weeks, and then 12 more weeks of CHD. All patients had been given vasopressors for severe DIH. RESULTS: The severe DIH disappeared during the short daily HD. There were significant decreases in body weight (BW), cardiothoracic ratio (CTR), blood pressure (BP), normal saline solution (NSS) amount (62.8 +/- 26.4 vs. 9.8 +/- 7.4 ml/session, p < 0.05), frequency (0.60 +/- 0.26 vs. 0.10 +/- 0.07 infusions/session, p < 0.05) and postdialysis atrial natriuretic peptide (ANP) (176.8 +/- 56.4 vs. 104.8 +/- 42.3 pg/ml, p < 0.05). Weekly ultrafiltration volume (6.3 +/- 0.9 vs. 7.9 +/- 0.7 l, p < 0.05) was significantly higher during the short daily HD period than during the first CHD period. The vasopressor treatment was therefore stopped or reduced in all patients during the short daily HD period. Because DIH recurred in the second CHD period despite a significant increase in BP, the vasopressor treatment was resumed in 5 patients. BW, CTR, NSS infusion amount and frequency, or postdialysis ANP did not differ significantly between the short daily HD and second CHD periods. CONCLUSIONS: The protective effect of short daily HD against DIH lasted more than 12 weeks after the treatment ended. We therefore conclude that temporary short daily HD is useful for preventing DIH. SN - 1420-4096 UR - https://www.unboundmedicine.com/medline/citation/15677874/Prolonged_protective_effect_of_short_daily_hemodialysis_against_dialysis_induced_hypotension_ L2 - https://www.karger.com?DOI=10.1159/000083586 DB - PRIME DP - Unbound Medicine ER -