Fluid-Shift during Computer-Modulated Profile Hemodialysis (Cmp-Hd)

Keuchel, Martin; Dittmar, A; Saure, B.; Laage, Ch.; Ebel, H.; Lange, H.

doi:10.1177/039139889101401005

Cited by 3 publications

(4 citation statements)

References 3 publications

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“…Patients with decreasing ICV claimed less discomfort than those with increasing ICV. From all symptoms, nausea and headache could be reduced significantly (p < 0.05, % 2 test), and only thirst was slightlv higher in patients with decreasing ICV [ 11].…”

Section: Dialysis C (Ns) Thirst Slightly Increased Only By Profile Cmentioning

confidence: 85%

“…Headache, cramps, fatigue, nausea, arterial hypertension and cardiac arrhythmias [1,10,11] are the main compli cations seen in patients subjected to extracorporeal ace tate haemodialysis and less frequently with bicarbonate dialysis. Although the underlying mechanisms are not always quite clear, uraemic disorders of the autonomic nervous system [5], volume depletion [1,3], fluid shifts from the extra-to the intracellular space [9] and steep, transmembraneous potassium gradients [10] have been shown to account for these complications.…”

Section: Discussionmentioning

confidence: 99%

“…Although the underlying mechanisms are not always quite clear, uraemic disorders of the autonomic nervous system [5], volume depletion [1,3], fluid shifts from the extra-to the intracellular space [9] and steep, transmembraneous potassium gradients [10] have been shown to account for these complications. Hence, com puter-modulated profile haemodialysis was designed to prevent these side-effects [11]. The dialysis equipment enabled to separate the variation in the ultrafiltration rate as well as the bath fluid concentration of sodium.…”

Section: Discussionmentioning

confidence: 99%

“…To avoid fluid shifts into the ICV without the disad vantage of a positive sodium balance, 15 elderly patients with end-stage renal disease and proven coronary heart disease were subjected to profile haemodialysis in which both the amount of fluid withdrawn by ultrafiltration and the sodium bath fluid concentration (DNa+) varied [10][11][12].…”

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confidence: 99%

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Impact of Profile Haemodialysis on Intra-/Extracellular Fluid Shifts and the Release of Vasoactive Hormones in Elderly Patients on Regular Dialysis Treatment

Ebel

Laage²,

Keuchel³

et al. 1997

Nephron

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In 15 patients with end-stage renal failure and proven coronary heart disease, profile haemodialysis with decreasing ultrafiltration rate and hyperionic, decreasing dialysate solute concentration was compared with conventional, extracorporeal bicarbonate haemodialysis (Na⁺_D =138 mmol/l). Body fluid distribution and the release of vasoactive hormones (plasma renin activity, aldosterone, norepinephrine, epinephrine, and atrial natriuretic peptide) were investigated. Haemodialysis with constant ultrafiltration rate and constant dialysate composition (A) was followed by two dialysis profiles: decreasing ultrafiltration rate (B) and additional hyperionic, decreasing dialysate sodium concentration (C). In all 15 patients, the dialysis procedures (A) – (C) were used for 2 weeks each with six sessions, the last being taken for investigation. Body fluid distribution was calculated. In patients with serum sodium above 136 mmol/l, the conventional dialysis (A) as well as the Uf profile (B) showed a net fluid shift from extracellular volume (ECV) to intracellular volume (ICV). Using the profile with hyperionic, decreasing Na⁺D (C), the reverse fluid shift with decreasing ICV was achieved not only in those with serum Na⁺ < 136 mmol/l, but also in those with serum Na⁺ ≥ 136 mmol/l. The release of vasoactive hormones decreased already at profile haemodialysis (B) compared with (A) and was further reduced in (C). These results would suggest, profile dialyses B and C to have less impact on the cardiovascular system in elderly patients assuming higher patient comfort compared with the standard dialysis procedure. A higher benefit was obtained in C compared with B, presumably due to the additional prevention of the ICV shift and plasma volume depletion in patients with initial serum sodium ≥ 136 mmol/l using transiently hyperionic Na⁺_D. These results show that in elderly patients, hyperionic profile haemodialysis (Na⁺_D > Na⁺s) had less impact on cardiovascular regulation than conventional bicarbonate dialysis.

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Section: Dialysis C (Ns) Thirst Slightly Increased Only By Profile Cmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Impact of Profile Haemodialysis on Intra-/Extracellular Fluid Shifts and the Release of Vasoactive Hormones in Elderly Patients on Regular Dialysis Treatment

Ebel

Laage²,

Keuchel³

et al. 1997

Nephron

Self Cite

View full text Add to dashboard Cite

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Dialysate sodium delivery can alter chronic blood pressure management

Flanigan

Khairullah

Lim

1997

American Journal of Kidney Diseases

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On-line Monitoring of the Intravascular Volume during Haemodialysis by Continuous Refractometry

Kuhlmann

Aziz

et al. 1999

Int J Artif Organs

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The control of intravascular volume (IVV) by continuous on-line measurement of protein concentration would optimise the patients' specific rate of ultrafiltration. To prove the accuracy of a refractometric device, plasma was continuously drawn by haemofiltration during 10 haemodialysis treatments of male patients. Refractometry reflects highly significant changes in the concentrations of filtrate proteins (r = 0.862, p < 0.001) and blood proteins (rtotal = 0.593, ptotal < 0.001). In vitro, the refractometric device detected a change of protein concentration of 0.041 g/L through a refraction increase of 0.1 mV. The power of discrimination was 0.067% of IVV However, in vivo, the accuracy of IVV refractometric monitoring is reduced by interference factors such as sodium (0. 141 mV/mmol/L), glucose (0.034 mV/mg/dl) and triglycerides (-0.040 mV/mg/dl). Adjustment of the refraction data using sodium and glucose electrodes and plasma filters with a cut-off below the size of chylomicrons is recommended.

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Fluid-Shift during Computer-Modulated Profile Hemodialysis (Cmp-Hd)

Cited by 3 publications

References 3 publications

Impact of Profile Haemodialysis on Intra-/Extracellular Fluid Shifts and the Release of Vasoactive Hormones in Elderly Patients on Regular Dialysis Treatment

Impact of Profile Haemodialysis on Intra-/Extracellular Fluid Shifts and the Release of Vasoactive Hormones in Elderly Patients on Regular Dialysis Treatment

Dialysate sodium delivery can alter chronic blood pressure management

On-line Monitoring of the Intravascular Volume during Haemodialysis by Continuous Refractometry

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