title: Prolonged protective effect of short daily hemodialysis against dialysis-induced hypotension.
abstract: OBJECTIVE
  Short daily hemodialysis (HD) has a protective effect against dialysis-induced hypotension (DIH). We examined whether this effect extends beyond the treatment period.
  
  
  METHODS
  We analyzed clinical variables in 6 patients (5 with diabetes mellitus) who underwent conventional hemodialysis (CHD) for 4 h three times weekly for 12 weeks; then short daily HD for 2 h six times weekly for 12 weeks, and then 12 more weeks of CHD. All patients had been given vasopressors for severe DIH.
  
  
  RESULTS
  The severe DIH disappeared during the short daily HD. There were significant decreases in body weight (BW), cardiothoracic ratio (CTR), blood pressure (BP), normal saline solution (NSS) amount (62.8 +/- 26.4 vs. 9.8 +/- 7.4 ml/session, p < 0.05), frequency (0.60 +/- 0.26 vs. 0.10 +/- 0.07 infusions/session, p < 0.05) and postdialysis atrial natriuretic peptide (ANP) (176.8 +/- 56.4 vs. 104.8 +/- 42.3 pg/ml, p < 0.05). Weekly ultrafiltration volume (6.3 +/- 0.9 vs. 7.9 +/- 0.7 l, p < 0.05) was significantly higher during the short daily HD period than during the first CHD period. The vasopressor treatment was therefore stopped or reduced in all patients during the short daily HD period. Because DIH recurred in the second CHD period despite a significant increase in BP, the vasopressor treatment was resumed in 5 patients. BW, CTR, NSS infusion amount and frequency, or postdialysis ANP did not differ significantly between the short daily HD and second CHD periods.
  
  
  CONCLUSIONS
  The protective effect of short daily HD against DIH lasted more than 12 weeks after the treatment ended. We therefore conclude that temporary short daily HD is useful for preventing DIH.
authors.affiliation: Division of Nephrology and Endocrinology, Department of Medicine, Nihon University School of Medicine,Tokyo, Japan. kokada@med.nihoniu.ac.jp
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Okada
authors.forename: Masanori
authors.initials: M
authors.lastname: Abe
authors.forename: Chihiro
authors.initials: C
authors.lastname: Hagi
authors.forename: Takashi
authors.initials: T
authors.lastname: Maruyama
authors.forename: Noriaki
authors.initials: N
authors.lastname: Maruyama
authors.forename: Ken
authors.initials: K
authors.lastname: Ito
authors.forename: Terumi
authors.initials: T
authors.lastname: Higuchi
authors.forename: Koichi
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Susumu
authors.initials: S
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D000740:Anemia / Q000097:blood / Q000209:etiology; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001071:Appointments and Schedules; D001166:Arteriovenous Shunt, Surgical; D009320:Atrial Natriuretic Factor / Q000097:blood; D001794:Blood Pressure; D001835:Body Weight; D003928:Diabetic Nephropathies / Q000628:therapy; D004452:Echocardiography; D004921:Erythropoietin / Q000008:administration & dosage; D005260:Female; D005293:Ferritins / Q000097:blood; D006801:Humans; D006977:Hypertension, Renal / Q000188:drug therapy / Q000209:etiology; D007022:Hypotension / Q000209:etiology* / Q000517:prevention & control*; D007501:Iron / Q000008:administration & dosage; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011788:Quality of Life; D011994:Recombinant Proteins; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods*; D014511:Uremia / Q000150:complications / Q000628:therapy
chemical_list: D000959:Antihypertensive Agents; D011994:Recombinant Proteins; D004921:Erythropoietin; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor; D005293:Ferritins; D007501:Iron