How does higher ultrafiltration within the conventional clinical range impact the volume status of hemodialysis patients?
OBJECTIVE
The higher ultrafiltration (UF) induces poor outcomes. The impact of higher UF on the volume status was investigated.


METHODS
60 hemodialysis (HD) patients were divided into three groups according to the ratio of total UF to post-dialysis body weight (TUF/PDW) (<3%, 3-5%, > or =5%). ANP, the ratio of extracellular water to total body water and excess fluid mass (ExF/PDW) by bioimpedance spectroscopy, inferior vena cava diameter by ultrasound were measured at the end of HD. The ratio of post-HD blood volume to pre-HD (BVpost/BVpre) and standardized filtration coefficients (Lpst) of the microvasculature in the vicinity of PDW were calculated.


RESULTS
Only Lpst and BVpost/BVpre showed significant differences among the three groups. A stepwise multiple linear regression model revealed that BVpost/BVpre was correlated with TUF/PDW, ExF/PDW and Lpst (R = 0.778, p < 0.001), independently.


CONCLUSIONS
Higher UF causes decreases in BVpost/BVpre and Lpst. BVpost/BVpre was determined by TUF/PDW, ExF/PDW and Lpst.
Yashiro
M
M
Division of Nephrology, Kyoto City Hospital, Kyoto, Japan. yashiro@pearl.ocn.ne.jp
Kamata
T
T
Segawa
H
H
Murakami
T
T
Kadoya
Y
Y
Muso
E
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001810:Blood Volume; D001834:Body Water; D017097:Electric Impedance; D045604:Extracellular Fluid; D005110:Extracellular Space; D006801:Humans; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*; D014462:Ultrafiltration / Q000009:adverse effects*; D014463:Ultrasonography; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging; D014882:Water-Electrolyte Balance