Hemodialysis crossover study using a relative blood volume change-guided ultrafiltration control compared with standard hemodialysis: the BV-UFC study

BackgroundIt has been difficult to sufficiently achieve body-fluid management using blood volume (BV) monitor during hemodialysis (HD) with constant ultrafiltration (UF) rate. Recently, a relative BV change-guided UF control (BV-UFC) system was developed by combining the concepts of an automatic fee...

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Published in:Renal replacement therapy 2020-10, Vol.6 (1), p.45-10, Article 45
Main Authors: Ookawara, Susumu, Ito, Kiyonori, Uchida, Takayuki, Tokuyama, Keito, Kiryu, Satoshi, Suganuma, Takeshi, Hojyo, Kyoko, Miyazawa, Haruhisa, Ueda, Yuichiro, Ito, Chiharu, Iimura, Osamu, Yoshiya, Kunihiko, Morishita, Yoshiyuki, Hanafusa, Norio, Tabei, Kaoru
Format: Article
Language:English
Subjects:
Angina pectoris
Automatic feedback system using blood volume monitoring
Blood
Blood pressure drop
Hemodialysis
Hemodynamics
Kidney diseases
Patients
Relative changes in blood volume
Ultrafiltration
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Summary:BackgroundIt has been difficult to sufficiently achieve body-fluid management using blood volume (BV) monitor during hemodialysis (HD) with constant ultrafiltration (UF) rate. Recently, a relative BV change-guided UF control (BV-UFC) system was developed by combining the concepts of an automatic feedback system that could control the UF rate and profile with real- time monitoring of relative changes in BV (%ΔBV). However, this system has limited application in the clinical setting. Therefore, in this study, we aimed to perform the crossover study on HD with BV-UFC compared to standard HD in terms of hemodynamic stability during HD.MethodsForty-eight patients entered an 8-week crossover period of standard HD or HD with BV-UFC. Prevalence of intradialytic hypotension (IDH) as a primary outcome and changes in blood pressure (BP), differences in %ΔBV, and achievement of the target ultrafiltration volume as secondary outcomes were compared. IDH was defined as a reduction in systolic BP ≥20 mmHg from the baseline value at 10 min after HD initiation.ResultsNo significant differences were found in the prevalence of IDH, frequency of intervention for symptomatic IDH, and achievement of the target ultrafiltration volume between the groups. The %ΔBV was significantly fewer (-12.1 ± 4.8% vs. -14.4 ± 5.2%, p
ISSN:2059-1381
2059-1381
DOI:10.1186/s41100-020-00295-8