A pilot study of routine colloid infusion in hypotension-prone dialysis patients unresponsive to preventive measures

Rostoker, Guy; Griuncelli, Mireille; Loridon, Christelle; Bourlet, Thomas; Illouz, Eric; Benmaadi, A.

doi:10.5301/jn.2011.6367

Cited by 18 publications

(24 citation statements)

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“…Intradialytic hypotension mitigating interventions for end‐stage renal disease patients include cool dialysate, albumin administration, sequential ultrafiltration (UF)‐HD and sodium modelling . Existing data suggest that sodium modelling mitigates IDH in the setting of routine ambulatory dialysis for end‐stage renal disease .…”

Section: Introductionmentioning

confidence: 99%

“…2 Evidence suggests that IDH impairs, and at times precludes renal recovery, [3][4][5] and is also independently associated with greater in-hospital mortality. 3 Intradialytic hypotension mitigating interventions for endstage renal disease patients include cool dialysate, 6 albumin administration, 7 sequential ultrafiltration (UF)-HD 8 and sodium modelling. 9 Existing data suggest that sodium modelling mitigates IDH in the setting of routine ambulatory dialysis for end-stage renal disease.…”

Section: Introductionmentioning

confidence: 99%

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Sodium modelling to reduce intradialytic hypotension during haemodialysis for acute kidney injury in the intensive care unit

Lynch

Ghassemi

Flythe³

et al. 2016

Nephrology

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Aim Intradialytic hypotension often complicates haemodialysis for patients with acute kidney injury (AKI), and may impact renal recovery. Sodium modeling is sometimes used as prophylaxis against intradialytic hypotension in the chronic haemodialysis population, but there is little evidence for its use among critically ill patients with AKI. Methods A retrospective cohort with AKI requiring intermittent haemodialysis in the intensive care unit from 2001–2008 was used to study the association of prophylactic sodium modeling and multiple outcomes. Outcomes included a composite of in-hospital death or dialysis dependence at hospital discharge, as well as intradialytic hypotension, ultrafiltration goal achievement, and net ultrafiltration volume. Associations were estimated using logistic regression, mixed linear models, and generalized estimating equations adjusting for demographic and clinical characteristics. Results 191 individuals who underwent 892 sessions were identified; sodium modeling was prescribed in 27.1% of the sessions. In adjusted analyses, sodium modeling was not significantly associated with intradialytic hypotension (p=0.67) or with the ultrafiltration goal achievement (p=0.06). Sodium modeling during the first dialysis session was numerically associated with lower risk for the composite of in-hospital death or dialysis dependence: adjusted OR (95% CI) 0.39 (0.15–1.02; p=0.06); however, this association did not reach statistical significance. Conclusion We did not observe statistically significant associations between sodium modeling and improved outcomes among AKI patients receiving intermittent dialysis in the intensive care unit. However, suggestive findings warrant further study.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sodium modelling to reduce intradialytic hypotension during haemodialysis for acute kidney injury in the intensive care unit

Lynch

Ghassemi

Flythe³

et al. 2016

Nephrology

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“…Sugars may aggravate the glucose intolerance encountered in dialysis, and the role of triglycerides, often added as calorie fuel to the intravenous mixture, in worsening atherosclerotic lesions is not clear. Nausea, muscle pain, infections, hyperglycemia, and complications linked to the dialysis procedure have occasionally been reported [126][127][128][129][130][131][132][133][134][135][136]. While baseline dyslipidemia is a contraindication for treatment, no target level based on an evidence-based position has yet been fixed [128].…”

Section: Intravenous Formulationsmentioning

confidence: 99%

“…Although the practice of albumin infusion in severely depleted dialysis patients is probably more frequent, there are very few studies that address this question. [136,137]. As in many cases of severely ill patients, both beneficial and negative effects are difficult to ascertain.…”

Section: Albumin (And Blood Transfusions)mentioning

confidence: 99%

“…While there are even fewer evidence-based studies on albumin infusion in dialysis patients, the few available ones suggest, as is logical to expect, that albumin infusion may have a favorable effect on intradialytic hypotension and a low risk of side effects. However, the advantages in the management of hypotension compared to saline infusion are not clear and probably cannot be generalized [135][136][137][138][139][140]. The high costs, the potential side effects, and, in particular, the risk of allergic reactions, need to be underlined.…”

Section: Albumin (And Blood Transfusions)mentioning

confidence: 99%

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Intradialytic Nutrition and Hemodialysis Prescriptions: A Personalized Stepwise Approach

et al. 2020

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Dialysis and nutrition are two sides of the same coin—dialysis depurates metabolic waste that is typically produced by food intake. Hence, dietetic restrictions are commonly imposed in order to limit potassium and phosphate and avoid fluid overload. Conversely, malnutrition is a major challenge and, albeit to differing degrees, all nutritional markers are associated with survival. Dialysis-related malnutrition has a multifactorial origin related to uremic syndrome and comorbidities but also to dialysis treatment. Both an insufficient dialysis dose and excessive removal are contributing factors. It is thus not surprising that dialysis alone, without proper nutritional management, often fails to be effective in combatting malnutrition. While composite indexes can be used to identify patients with poor prognosis, none is fully satisfactory, and the definitions of malnutrition and protein energy wasting are still controversial. Furthermore, most nutritional markers and interventions were assessed in hemodialysis patients, while hemodiafiltration and peritoneal dialysis have been less extensively studied. The significant loss of albumin in these two dialysis modalities makes it extremely difficult to interpret common markers and scores. Despite these problems, hemodialysis sessions represent a valuable opportunity to monitor nutritional status and prescribe nutritional interventions, and several approaches have been tried. In this concept paper, we review the current evidence on intradialytic nutrition and propose an algorithm for adapting nutritional interventions to individual patients.

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Alternative Clinical Trial Designs for Nephrology Research

Agarwal

Guedes

Pécoits-Filho

et al. 2022

Innovations in Nephrology

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A pilot study of routine colloid infusion in hypotension-prone dialysis patients unresponsive to preventive measures

Cited by 18 publications

References 0 publications

Sodium modelling to reduce intradialytic hypotension during haemodialysis for acute kidney injury in the intensive care unit

Sodium modelling to reduce intradialytic hypotension during haemodialysis for acute kidney injury in the intensive care unit

Intradialytic Nutrition and Hemodialysis Prescriptions: A Personalized Stepwise Approach

Alternative Clinical Trial Designs for Nephrology Research

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