Changes in extracellular water with hemodialysis and fall in systolic blood pressure

Tangvoraphonkchai, Kamonwan; Davenport, Andrew

doi:10.1177/0391398821995503

Cited by 6 publications

(3 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Understanding the optimal fluid volume balance will facilitate the clinical application of body fluid assessment methods. A recent study revealed an association between the reduction in ECW and systolic blood pressure (SBP) with dialysis, and researchers advocated monitoring changes in ECW during dialysis to reduce the risk of intradialytic hypotension ( 53 ). This study showed that the TBW, ICW, and ECW values in females increased first and then decreased thereafter during the lifetime, with peak values appearing in the 41~ group.…”

Section: Discussionmentioning

confidence: 99%

Normative reference data for body composition in healthy indigenous populations on the Qinghai-Tibet Plateau

Li²,

Huang³

et al. 2022

Front. Public Health

View full text Add to dashboard Cite

Body composition represents an important aspect of physical fitness and has received increasing attention in recent years. The present study was designed and conducted to provide reference values for age-, sex-, and altitude-specific body composition for healthy indigenous Tibetan adults living on the Qinghai-Tibet Plateau, which has not yet been studied. A cross-sectional survey was conducted among 2,356 healthy Tibetan adults (1,433 females and 923 males) living on the Qinghai-Tibet Plateau for generations. The body composition of the participants was measured by bioelectrical impedance analysis (BIA). The measurements included weight, basal metabolic rate (BMR), fat-free mass (FFM), skeletal muscle mass (SMM), protein mass (PM), bone mass (BM), fat mass (FM), percentage of body fat (PBF), subcutaneous fat mass (SFM), visceral fat mass (VFM), total body water (TBW), intracellular water (ICW), and extracellular water (ECW). Overall, males had greater FFM, SMM, PM, BM, and water mass, whereas females were high in fat mass. Participants from plains generally had higher body composition values, and PM, BM, FM and body water values decreased with increasing altitude, with the lowest values found in >4,000 m Shigatse. FFM, SMM, PM, and BM tended to decrease with increasing age, whereas fat mass and ECW tended to increase with increasing age. This study provides the first normative reference data of body composition for healthy indigenous individuals on the Qinghai-Tibet Plateau. These datasets are important for future research related to body composition. A considerable decrease in body composition values in > 4,000 m-altitude areas suggested that body composition cutoff values should be established by altitude. Age-, sex-, and altitude-specific alterations in body composition values also inform the prevention and amendment of abnormal body composition changes and resultant health complications.

show abstract

Section: Discussionmentioning

confidence: 99%

Normative reference data for body composition in healthy indigenous populations on the Qinghai-Tibet Plateau

Li²,

Huang³

et al. 2022

Front. Public Health

View full text Add to dashboard Cite

show abstract

“…Previous studies have shown the body water, including total body water, intracellular water and extracellular water are positively correlated with blood pressure in different patients, including those with chronic kidney disease [ 33 ], those on hemodialysis and those with primary hypertension [ 34 , 35 ]. Blood pressure is sensitive to extracellular body water; extracellular water overhydration was significantly greater in patients whose blood pressures increased post dialysis [ 36 , 37 ]. We also found that the association between decreased blood pressure and reduced extracellular body water in DASH + TRE group.…”

Section: Discussionmentioning

confidence: 99%

Effects of DASH diet with or without time-restricted eating in the management of stage 1 primary hypertension: a randomized controlled trial

Zhou,

Lin,

et al. 2024

Nutr J

View full text Add to dashboard Cite

Background Time-restricted eating (TRE), a popular form of intermittent fasting, has shown benefits for improving metabolic diseases and cardiometabolic health. However, the effect of TRE in the regulation of blood pressure in primary hypertension remains unclear. Methods A 6-week randomized controlled trial was conducted, in which a total of 74 stage 1 primary hypertensive patients without high-risk were randomly assigned to Dietary Approaches to Stop Hypertension (DASH) group (n = 37) or DASH + TRE group (n = 37). Participants in the DASH + TRE group were instructed to consume their food within an 8-h window. Scientific research platform in We Chat application was used to track participants. The primary outcome was blood pressure. The secondary outcomes included body composition, cardiometabolic risk factors, inflammation-related parameters, urinary Na+ excretion, other clinical variables and safety outcomes. Results The reduction of systolic blood pressure and diastolic blood pressure were 5.595 ± 4.072 and 5.351 ± 5.643 mm Hg in the DASH group and 8.459 ± 4.260 and 9.459 ± 4.375 mm Hg in the DASH + TRE group. DASH + TRE group improved blood pressure diurnal rhythm. Subjects in DASH + TRE group had decreased extracellular water and increased urinary Na+ excretion. Furthermore, the decrease in blood pressure was associated with a reduction of extracellular water or increase in urinary Na+ excretion. In addition, safety outcomes such as nighttime hunger were also reported. Conclusion Our study demonstrated that 8-h TRE + DASH diet caused a greater decrease in blood pressure in stage 1 primary hypertensive patients than DASH diet. This study may provide novel insights into the benefits of lifestyle modification in the treatment of primary hypertension. Trial registration https://www.chictr.org.cn/ (ChiCTR2300069393, registered on March 15, 2023).

show abstract

“…The "dry weight" assessment-based approach, although necessary from a clinical perspective and unquestionably beneficial toward improving CV outcomes is cumbersome and difficult to apply in daily routine, has been conceptually challenged and incurs additional costs [28,46,[99][100][101]. More objective and precise approaches that rely on biomarkers and automated technical tools to support clinical decision-making for sodium, fluid, and BP managements are therefore needed [102].…”

Section: Strategies and Tools To Mitigate The Sodium-fluid Overload I...mentioning

confidence: 99%

Personalized Management of Sodium and Volume Imbalance in Hemodialysis to Mitigate High Costs of Hospitalization

Hornig¹,

Canaud²,

Bowry³

2023

Blood Purif

View full text Add to dashboard Cite

The primary objective of hemodialysis (HD) is lowering concentrations of organic uremic toxins that accumulate in blood in end-stage kidney disease (ESKD) and redress imbalances of inorganic compounds in particular sodium and water. Removal by ultrafiltration of excess fluid that has accumulated during the dialysis-free interval is a vital aspect of each HD session. Most HD patients are volume overloaded, with ∼25% of patients having severe (>2.5 L) fluid overload (FO). The potentially serious complications of FO contribute to the high cardiovascular morbidity and mortality observed in the HD population. Weekly cycles imposed by the schedule of HD treatments create a deleterious and unphysiological “tide phenomenon” marked by sodium-volume overload (loading) and depletion (unloading). Fluid overload-related hospitalizations are frequent and costly, with average cost estimates of $ 6,372 per episode, amounting to some $ 266 million total costs over a 2-year period in a US dialysis population. Various strategies (e.g., dry weight management or use of fluids with different sodium concentrations) have been attempted to rectify FO in HD patients but have met with limited success largely due to imprecise and cumbersome, or costly, approaches. In recent years, conductivity-based technologies have been refined to actively restore sodium and fluid imbalance and maintain the predialysis plasma sodium set point (plasma tonicity) of each patient. By automatically controlling the dialysate-plasma sodium gradient based on the specific patient needs throughout a session, an individualized sodium dialysate prescription can be delivered. Maintaining precise sodium mass balance helps better control of blood pressure, reduces FO, and thus tends to prevent hospitalization for congestive heart failure. We present the case for personalized salt and fluid management via a machine-integrated sodium management tool. Results from proof-of-principle clinical trials indicate that the tool enables individualized sodium-fluid volume control during each HD session. Its application in routine clinical practice has the potential to mitigate the substantial economic burden of hospitalizations attributed to volume overload complications in HD. Additionally, such a tool would contribute toward reduced symptomology and dialysis-induced multiorgan damage in HD patients and to improving their treatment perception and quality of life which matters most to patients.

show abstract

Changes in extracellular water with hemodialysis and fall in systolic blood pressure

Cited by 6 publications

References 30 publications

Normative reference data for body composition in healthy indigenous populations on the Qinghai-Tibet Plateau

Normative reference data for body composition in healthy indigenous populations on the Qinghai-Tibet Plateau

Effects of DASH diet with or without time-restricted eating in the management of stage 1 primary hypertension: a randomized controlled trial

Personalized Management of Sodium and Volume Imbalance in Hemodialysis to Mitigate High Costs of Hospitalization

Contact Info

Product

Resources

About