Dying to Feel Better

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

“…3,82 Although no RCTs have demonstrated that lowering UF rates improves outcomes, biologic plausibility data support a relationship between higher UF rates and end-organ ischemia (heart, brain, liver, gut, kidneys). [83][84][85][86][87][88][89] A critical unanswered question is how to balance the potential risks from higher UF rates with the potential risks from volume overload. 80 In the absence of conclusive data, using one specific UF rate threshold for all patients at all times is likely inappropriate.…”

Wearable sensors: can they benefit patients with chronic kidney disease?

“…Yet, specific importance of blood oxygenation monitoring during dialysis has recently been highlighted [3,54]. SpO 2 monitoring also offers great potential for wearable measurement in CVD, CHF, and COPD.…”

“…From these two, transplantation is by far the preferred treatment (provided the patient is suited for it), but there is a shortage of donor organs. Unfortunately, despite the undoubted usefulness as a life-maintaining therapy, chronic dialysis itself inflicts collateral damage that accumulates over the years, especially with regard to CVD, which may augment the pathology related to renal failure per se [3]. Other comorbidities in dialysis patients are renal bone disease and diabetes.…”

Effect of ultrafiltration on placental‐fetal blood flow in pregnancy of woman undergoing chronic hemodialysis

“…The expected weight gain in the first trimesters is minimal (0.5–1.5 kg/trimester), while from the 24th week of gestation weight gain recommended is up to 0.5 kg/wk and 11.5 to 16 kg during the pregnancy for women at their ideal body weight . Conversely, most of weight gain in interdialytic period is of fluid and an over aggressive UF with removal of significant amounts of fluid can results in circulatory stress and hypotension, associated with poor tissue perfusion of various body tissues and also increase incidence of thrombosis …”

“…4 Conversely, most of weight gain in interdialytic period is of fluid and an over aggressive UF with removal of significant amounts of fluid can results in circulatory stress and hypotension, associated with poor tissue perfusion of various body tissues and also increase incidence of thrombosis. 5 Ultrafiltration rate can be minimized by extending dialysis time and with the maintenance of residual kidney function. Residual kidney function play an inverse role in the required amount of fluid to be withdrawn by the UF and it is frequently present at the start of renal replacement therapy, but reduces over time.…”