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Effects of relative blood volume-controlled hemodialysis on blood pressure and volume status in hypertensive patients.
ASAIO J. 2007 May-Jun; 53(3):357-64.AJ

Abstract

In hypertensive hemodialysis (HD) patients, dry weight reduction to normalize blood pressure (BP) often results in increased frequency of HD hypotension. Because HD with blood volume tracking (BVT) has been shown to improve intra-HD hemodynamic stability, we performed a prospective, randomized study to test whether BVT is more effective than standard hemodialysis (SHD) in the management of hypertension by dry weight reduction. After a run-in period of 4 weeks on SHD, 28 patients were randomly assigned for a 12-week treatment period with either SHD (n = 14) or BVT (n = 14). The mean pre-HD and post-HD weight did not change over time in either group. In the BVT group, pre-HD systolic and diastolic BP decreased on average 22.5 mm Hg and 8.3 mm Hg, respectively (both p < 0.05), whereas BP did not change in the SHD group. Extracellular water and cardiothoracic ratio decreased significantly (all p < 0.05) in the BVT group but not in the SHD group. Brain natriuretic peptide levels declined only in the BVT group, without reaching statistical significance. The frequency of HD hypotensive episodes decreased significantly (p < 0.05) in the BVT group and was unchanged in the SHD group. HD with BVT was associated with a significant reduction in pre-HD BP. At the same time, the frequency of intra-HD hypotensive episodes decreased. Although the mean weight did not change, the reductions in cardiothoracic ratio and extracellular water suggest that HD with BVT resulted in optimization of volume status.

Authors+Show Affiliations

Dialysis Centre Groningen, University Medical Centre Groningen, Groningen, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

17515729

Citation

Dasselaar, Judith J., et al. "Effects of Relative Blood Volume-controlled Hemodialysis On Blood Pressure and Volume Status in Hypertensive Patients." ASAIO Journal (American Society for Artificial Internal Organs : 1992), vol. 53, no. 3, 2007, pp. 357-64.
Dasselaar JJ, Huisman RM, de Jong PE, et al. Effects of relative blood volume-controlled hemodialysis on blood pressure and volume status in hypertensive patients. ASAIO J. 2007;53(3):357-64.
Dasselaar, J. J., Huisman, R. M., de Jong, P. E., Burgerhof, J. G., & Franssen, C. F. (2007). Effects of relative blood volume-controlled hemodialysis on blood pressure and volume status in hypertensive patients. ASAIO Journal (American Society for Artificial Internal Organs : 1992), 53(3), 357-64.
Dasselaar JJ, et al. Effects of Relative Blood Volume-controlled Hemodialysis On Blood Pressure and Volume Status in Hypertensive Patients. ASAIO J. 2007 May-Jun;53(3):357-64. PubMed PMID: 17515729.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of relative blood volume-controlled hemodialysis on blood pressure and volume status in hypertensive patients. AU - Dasselaar,Judith J, AU - Huisman,Roel M, AU - de Jong,Paul E, AU - Burgerhof,Johannes G M, AU - Franssen,Casper F M, PY - 2007/5/23/pubmed PY - 2007/6/28/medline PY - 2007/5/23/entrez SP - 357 EP - 64 JF - ASAIO journal (American Society for Artificial Internal Organs : 1992) JO - ASAIO J VL - 53 IS - 3 N2 - In hypertensive hemodialysis (HD) patients, dry weight reduction to normalize blood pressure (BP) often results in increased frequency of HD hypotension. Because HD with blood volume tracking (BVT) has been shown to improve intra-HD hemodynamic stability, we performed a prospective, randomized study to test whether BVT is more effective than standard hemodialysis (SHD) in the management of hypertension by dry weight reduction. After a run-in period of 4 weeks on SHD, 28 patients were randomly assigned for a 12-week treatment period with either SHD (n = 14) or BVT (n = 14). The mean pre-HD and post-HD weight did not change over time in either group. In the BVT group, pre-HD systolic and diastolic BP decreased on average 22.5 mm Hg and 8.3 mm Hg, respectively (both p < 0.05), whereas BP did not change in the SHD group. Extracellular water and cardiothoracic ratio decreased significantly (all p < 0.05) in the BVT group but not in the SHD group. Brain natriuretic peptide levels declined only in the BVT group, without reaching statistical significance. The frequency of HD hypotensive episodes decreased significantly (p < 0.05) in the BVT group and was unchanged in the SHD group. HD with BVT was associated with a significant reduction in pre-HD BP. At the same time, the frequency of intra-HD hypotensive episodes decreased. Although the mean weight did not change, the reductions in cardiothoracic ratio and extracellular water suggest that HD with BVT resulted in optimization of volume status. SN - 1538-943X UR - https://www.unboundmedicine.com/medline/citation/17515729/Effects_of_relative_blood_volume_controlled_hemodialysis_on_blood_pressure_and_volume_status_in_hypertensive_patients_ L2 - https://doi.org/10.1097/MAT.0b013e318031b513 DB - PRIME DP - Unbound Medicine ER -