Blood pressure and volume management in dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Flythe, Jennifer E.; Chang, Tara I.; Gallagher, Martin; Lindley, Elizabeth; Madero, Magdalena; Sarafidis, Pantelis; Unruh, Mark; Wang, Angela Yee-Moon; Weiner, Daniel E.; Cheung, Michael; Jadoul, Michel; Winkelmayer, Wolfgang C.; Polkinghorne, Kevan R; Adragão, Teresa; Anumudu, Samaya; Chan, Christopher T.; Cheung, Alfred K.; Costanzo, María Rosa; Dasgupta, Indranil; Davenport, Andrew; Davies, Simon; Dekker, Marijke; Dember, Laura M.; Gallego, Daniel; Gómez, Rafael; Hawley, Carmel M.; Hecking, Manfred; Iseki, Kunitoshi; Jha, Vivekanand; Kooman, Jeroen P.; Kövesdy, Csaba P.; Lacson, Eduardo; Liew, Adrian; Lok, Charmaine E.; McIntyre, Christopher W.; Mehrotra, Rajnish; Miskulin, Dana C.; Movilli, Ezio; Paglialonga, Fabio; Pécoits-Filho, Roberto; Perl, Jeff; Pollock, Carol; Riella, Miguel C.; Rossignol, Patrick; Shroff, Rukshana; Solá, Laura; Søndergaard, Henning; Tang, Sydney C.W.; Tong, Allison; Tsukamoto, Yusuke; Watnick, Suzanne; Weir, Matthew R.; Wetmore, James B.; Wilkie, Caroline; Wilkie, Martin

doi:10.1016/j.kint.2020.01.046

Cited by 136 publications

(136 citation statements)

References 175 publications

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“…Tekanan darah pasien dialisis berdampak pada gejala pasien, kualitas hidup, dan komplikasi kardiovaskular [13]. Hipertensi intradialitik pada pasien hemodialisis rutin dikaitkan dengan peningkatan mortalitas .…”

Section: Pendahuluanunclassified

Improving Quality of Life in Hemodialysis Patients with Intradialysis Hypertension Using “SEHAT” Nursing Interventions

Armiyati

Hadisaputro

Chasani³

et al. 2021

mki

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Intradialytic hypertension can reduce the quality of life in hemodialysis patients. Providing appropriate nursing interventions will reduce morbidity, and improve the quality of intradialytic hypertensive patients. Provision of “SEHAT” nursing intervention package in the form of providing support, education and empowering, holistically with attention to therapeutic sensitivity can be applied to overcome patients problems. The purpose of the study was to analyze the "SEHAT" nursing intervention package to improve the quality of life of intradialytic hypertensive patients. The research method was a randomized controlled trial on 40 samples of hemodialysis patients which were divided into 20 group samples and 20 control group samples. The research instrument uses the Indonesian version of the Kidney Disease Quality of Life (KDQOL-36). The intervention was carried out for 4 weeks using the SEHAT nursing intervention package. The results showed an increase in the quality of life scores of respondents in the intervention group after being given SEHAT nursing intervention (p=0.000). There was a significant difference in the quality of life scores between the intervention group and the control group after being given the intervention (p=0.000). The “SEHAT” nursing intervention package is effective for improving the quality of life of intradialytic hypertensive patients.

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Section: Pendahuluanunclassified

Improving Quality of Life in Hemodialysis Patients with Intradialysis Hypertension Using “SEHAT” Nursing Interventions

Armiyati

Hadisaputro

Chasani³

et al. 2021

mki

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“…Based on these remarks, IVC diameters should be performed and interpreted by an experienced cardiologist. Finally, as discussed above, one should keep in mind that IVC estimates only intravascular (preload) volume and has a rather low reproducibility [24].…”

Section: Ivc Diametermentioning

confidence: 99%

“…Their elevated levels independently identify a subset of patients at greater risk for death, but they cannot be used to assess volume status [38]. Further, the levels of these peptides may be affected by underlying heart function and are not universally available [24].…”

Section: Natriuretic Peptidesmentioning

confidence: 99%

Assessment of Hydration Status in Peritoneal Dialysis Patients: Validity, Prognostic Value, Strengths, and Limitations of Available Techniques

2020

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Background: The majority of patients undergoing peritoneal dialysis (PD) suffer from volume overload and this overhydration is associated with increased mortality. Thus, optimal assessment of volume status in PD is an issue of paramount importance. Patient symptoms and physical signs are often unreliable indexes of true hydration status. Summary: Over the past decades, a quest for a valid, reproducible, and easily applicable technique to assess hydration status is taking place. Among existing techniques, inferior vena cava diameter measurements with echocardiography and natriuretic peptides such as brain natriuretic peptide and N-terminal pro-B-type natriuretic peptide were not extensively examined in PD populations; while having certain advantages, their interpretation are complicated by the underlying cardiac status and are not widely available. Bioelectrical impedance analysis (BIA) techniques are the most studied tool assessing volume overload in PD. Volume overload assessed with BIA has been associated with technique failure and increased mortality in observational studies, but the results of randomized trials on the value of BIA-based strategies to improve volume-related outcomes are contradictory. Lung ultrasound (US) is a recent technique with the ability to identify volume excess in the critical lung area. Preliminary evidence in PD showed that B-lines from lung US correlate with echocardiographic parameters but not with BIA measurements. This review presents the methods currently used to assess fluid status in PD patients and discusses existing data on their validity, applicability, limitations, and associations with intermediate and hard outcomes in this population. Key Message: No method has proved its value as an intervening tool affecting cardiovascular events, technique, and overall survival in PD patients. As BIA and lung US estimate fluid overload in different compartments of the body, they can be complementary tools for volume status assessment.

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“…Effective peridialysis blood pressure and other cardiovascular function control is necessary for the delivery of an adequate dialysis dose and attainment of optimal clinical outcome. 1 The blood pressure (BP) is a key indicator of extracellular volume (ECV) and an index of the cardiac reserve in health and disease. 2 A very high prevalence of hypertension (HTN) and other cardiovascular diseases is reported amongst CKD patients, particularly in end stage, with 57% of the hypertensive population in Ghana found to have poorly treated hypertension.…”

Section: Introductionmentioning

confidence: 99%

Intradialysis hypotension and hypertension in patients with end stage kidney disease in Nigeria: risk factors and clinical correlates

Uduagbamen

Kadiri

2021

gmj

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Background: Many shortcomings associated with haemodialysis for instance, intradialysis blood pressure changes, often lead to inadequate dialysis dose. Measures are needed to improve on this.Objectives: To determine the risk factors and clinical correlates of intradialysis blood pressure variations.Methods: Maintenance haemodialysis sessions for 232 consented patients with end stage kidney disease who had 1248 sessions were studied. Data collected was from history, examination findings, serum electrolytes and hematocrit. Blood pressure reading was taken manually at rest. Statistical analysis was with SPSS 22. Chi square and t-test were used to compare proportions and means respectively while regression analysis was used to determine predictors of blood pressure changes.Results: The mean age of participants was 49.9 + 4.6. More participants (38.8%) had hypertension associated CKD, than chronic glomerulonephritis, (37.9%). Majority (60.7%) had internal jugular catheter. Intradialysis hypertension was commoner than intradialysis hypotension (24.4% versus 19.4%). Intradialysis hypotension was commoner in females, diabetics and with less frequent dialysis while intradialysis hypertension was commoner in males, frequent erythropoietin use. The mean dialysis dose (Kt/V) was 1.02 + 0.4, with 0.68 + 0.1for intradialysis hypotension and 0.84 + 0.2 for intradialysis hypertension.Conclusion: Risk factors for intradialysis hypertension were males, frequent erythropoietin use while for intradialysis hypotension, were female gender and less frequent dialysis. Effective intra and inter-dialytic blood pressure control with adequate pre dialysis work up should be carried out to lessen the degree, burden and outcome of these variations.

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Blood pressure and volume management in dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Abstract: Research recommendations within each topic area are listed in order of priority, stratified by modality type.JE Flythe et al.: BP and volume control in dialysis: a KDIGO conference report

Cited by 136 publications

References 175 publications

Improving Quality of Life in Hemodialysis Patients with Intradialysis Hypertension Using “SEHAT” Nursing Interventions

Improving Quality of Life in Hemodialysis Patients with Intradialysis Hypertension Using “SEHAT” Nursing Interventions

Assessment of Hydration Status in Peritoneal Dialysis Patients: Validity, Prognostic Value, Strengths, and Limitations of Available Techniques

Intradialysis hypotension and hypertension in patients with end stage kidney disease in Nigeria: risk factors and clinical correlates

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