title: Association of intradialytic hypotension and convective volume in hemodiafiltration: results from a retrospective cohort study.
abstract: BACKGROUND
  Hemodiafiltration (HDF), as a convective blood purification technique, has been associated with favorable outcomes improved phosphate control, removal of middle-molecules such as Beta2-microglobulin and the occurrence of intradialytic hypotension (IDH) as compared to diffusive techniques. The aim of this retrospective cohort study in dialysis patients receiving HDF in one urban dialysis facility in Mexico City was to investigate the occurrence of IDH during HDF treatments with varying convective volume prescriptions.
  
  
  METHODS
  Subjects were stratified into equal groups of percentiles of convective volume prescription: Group 1 of 0 to 7.53 liters, group 2 of 7.54 to 14.8 liters, group 3 of 14.9 to 16.96 liters, group 4 of 16.97 to 18.9 liters, group 5 of 21 to 19.9 liters and group 6 of 21.1 to 30 liters. Logistic Regression with and without adjustment for confounding factors was used to evaluate factors associated with the occurrence of IDH.
  
  
  RESULTS
  2276 treatments of 154 patients were analyzed. IDH occurred during 239 HDF treatments (10.5% of all treatments). Group 1 showed 31 treatments (8.2%) with IDH whereas group 6 showed IDH in only 15 sessions (4% of all treatments). Odds Ratio of IDH for Group 6 was 0.47 (95% CI 0.25 to 0.88) as compared to Group 1 after adjustment.
  
  
  CONCLUSIONS
  In summary the data of this retrospective cohort study shows an inverse correlation between the occurrence of IDH and convective volume prescription. Further research in prospective settings is needed to confirm these findings.
authors.affiliation: Servicio de Nefrología, Hospital José Carrasco Arteaga, Cuenca, Ecuador. franklin.mora.bravo@gmail.com
authors.forename: Franklin G
authors.initials: FG
authors.lastname: Mora-Bravo
authors.forename: Guadalupe
authors.initials: G
authors.lastname: De-La-Cruz
authors.forename: Sonia
authors.initials: S
authors.lastname: Rivera
authors.forename: Alfonso Mariscal
authors.initials: AM
authors.lastname: Ramírez
authors.forename: Jochen G
authors.initials: JG
authors.lastname: Raimann
authors.forename: Héctor
authors.initials: H
authors.lastname: Pérez-Grovas
mesh_terms: D000328:Adult; D001810:Blood Volume; D001811:Blood Volume Determination / Q000706:statistics & numerical data*; D015984:Causality; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D017583:Hemodiafiltration / Q000706:statistics & numerical data*; D006801:Humans; D007022:Hypotension / Q000453:epidemiology* / Q000503:physiopathology; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000534:rehabilitation*; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome