title: Prevention of intradialytic hypotension in patients with acute kidney injury submitted to sustained low-efficiency dialysis.
abstract: OBJECTIVE
  This study evaluated the effects of a protocol aiming to reduce hypotension in acute kidney injury (AKI) patients submitted to sustained low-efficiency dialysis (SLED).
  
  
  METHODS
  Patients were randomly assigned to two SLED prescriptions-control group, dialysate temperature was 37.0°C with a fixed sodium concentration [138 mEq/L] and ultrafiltration (UF) rate; and profiling group, dialysate temperature was 35.5°C with a variable sodium concentration [150-138 mEq/L] and UF rate.
  
  
  RESULTS
  Sixty-two SLED sessions were evaluated (34 in profiling and 28 in control). Patients (n = 31) were similar in terms of gender, age, and Sequential Organ Failure Assessment (SOFA) score. Dialysis time, dialysis dose, and post-dialysis serum sodium were similar in both groups. The profiling group had significantly less hypotension episodes (23% vs. 57% in control, p = 0.009) and achieved higher UF volume (2.23 ± 1.25 L vs. 1.59 ± 1.03 L in control, p = 0.04) when compared with control group.
  
  
  CONCLUSIONS
  SLED protocol with modulation of dialysate temperature, sodium, and UF profiling showed similar efficacy but less intradialytic hypotension when compared with a standard SLED prescription.
authors.affiliation: Division of Nephrology, Hospital de Base, Sao Jose do Rio Preto Medical School, Sao Jose do Rio Preto, Brazil. equintino@uol.com.br
authors.forename: Emerson Q
authors.initials: EQ
authors.lastname: Lima
authors.forename: Ricardo G
authors.initials: RG
authors.lastname: Silva
authors.forename: Endrigo L S
authors.initials: EL
authors.lastname: Donadi
authors.forename: Alex B
authors.initials: AB
authors.lastname: Fernandes
authors.forename: Jeferson R
authors.initials: JR
authors.lastname: Zanon
authors.forename: Klinger R D
authors.initials: KR
authors.lastname: Pinto
authors.forename: Emmanuel A
authors.initials: EA
authors.lastname: Burdmann
mesh_terms: D058186:Acute Kidney Injury / Q000628:therapy*; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods*