Isonatric dialysis biofeedback in hemodiafiltration with online regeneration of ultrafiltrate (HFR): rationale and study protocol for a randomized controlled study.
Dialysate sodium prescription has major implications for hemodialysis tolerance but also for dialyzed patients' cardiovascular morbidity as a determinant factor of blood pressure. Biofeedback systems have been developed to drive dialysate conductivity in order to reach a prescribed serum sodium concentration, indirectly evaluated by a dialysate or an ultrafiltrate conductivity measurement. A biofeedback system using hemodiafiltration with online regeneration of ultrafiltrate (HFR) has been specially developed with an isonatric mode maintaining an equal serum sodium concentration between start and end of the dialysis session, combined with ultrafiltration and conductivity profiles. We hypothesized that using this biofeedback in an isonatric mode would have a beneficial effect on blood pressure and dialysis tolerance. The study protocol has been approved by our ethics committee and is presented herein.
Nephrology Department, Pitié Salpêtrière Hospital, Public Assistance Hospitals of Paris, Paris, France. lucile.mercadal@psl.aphp.fr
Lucile
L
Mercadal
Céline
C
Piékarski
Jean-Louis
JL
Renaux
Thierry
T
Petitclerc
Gilbert
G
Deray
D001331:Automation; D001676:Biofeedback, Psychology / Q000295:instrumentation*; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D015314:Dialysis Solutions / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D004553:Electric Conductivity; D004867:Equipment Design; D017583:Hemodiafiltration / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D009862:Online Systems; D010297:Paris; D011446:Prospective Studies; D012107:Research Design; D012964:Sodium / Q000097:blood*; D013813:Therapy, Computer-Assisted / Q000295:instrumentation*; D013997:Time Factors; D016896:Treatment Outcome
D015415:Biomarkers; D015314:Dialysis Solutions; D012964:Sodium