title: The recovery of the fluid balance after hemodialysis and hemofiltration.
abstract: Dialysis dysequilibrium syndrome is a frequent complication of renal replacement therapy and seems to be related to changes in fluid balance. From previous studies it is known that these changes are less pronounced during hemofiltration (HF), leading to a lower incidence of complaints compared to hemodialysis (HD). To assess the severity and duration of the dysequilibrium syndrome, intracellular (ICV) and extracellular fluid volumes (ECV) were measured during and after HD and HF by means of a non-invasive conductivity method. Blood volume changes were calculated from pre- and post-treatment erythrocyte counts. Seven HD and eight HF patients were studied. Ultrafiltration volume did not differ between both groups. Blood volume decrease was less during HF due to a significant decrease in ICV, the latter being in contrast to an ICV increment during HD. The significant decrease in ICV led to a less severe decrease in ECV (90 versus 85%). Overall, this resulted in a better vascular refill during HF. At the end of treatment ICV and ECV were not in equilibrium yet. During the recovery period ICV increased roughly 3% in the HF group. In the HD group some patients showed an increase while others showed a decrease in ICV. Overall, no change in ICV was noticed. During recovery ECV decreased further in both groups. The measured recovery period was significantly shorter after HF (245 +/- 68 min) than after HD (299 +/- 37), supporting the hypothesis that HF is a more physiological way of treatment compared to HD.
authors.affiliation: Dept. of Internal Medicine, Free University Hospital, Amsterdam, The Netherlands.
authors.forename: C G
authors.initials: CG
authors.lastname: Olthof
authors.forename: P M
authors.initials: PM
authors.lastname: de Vries
authors.forename: P M
authors.initials: PM
authors.lastname: Kouw
authors.forename: P L
authors.initials: PL
authors.lastname: Oe
authors.forename: P G
authors.initials: PG
authors.lastname: Gerlag
authors.forename: H
authors.initials: H
authors.lastname: Schneider
authors.forename: A J
authors.initials: AJ
authors.lastname: Donker
mesh_terms: D000368:Aged; D001810:Blood Volume / Q000502:physiology; D005110:Extracellular Space / Q000502:physiology; D005260:Female; D006440:Hemofiltration / Q000009:adverse effects*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D013997:Time Factors; D014882:Water-Electrolyte Balance / Q000502:physiology*; D014883:Water-Electrolyte Imbalance / Q000209:etiology* / Q000503:physiopathology