title: Hemodynamic Response to Hemodialysis With Ultrafiltration Rate Profiles Either Gradually Decreasing or Gradually Increasing.
abstract: Hemodialysis (HD) is usually performed with the gradually decreasing ultrafiltration rate (UFR) profile (dUFR). The aim of the present study was to compare the hemodynamic response to HD with the dUFR to that of HD with the gradually increasing UFR profile (iUFR). The study population included 10 patients (three women, mean age: 28 ± 8 years) undergoing maintenance HD who had reached dry weight without taking antihypertensive medications. Each patient received (in random order) one HD session with the dUFR and another with the iUFR (both with 3 h total UFR = 2200 mL). Hemodynamic response was evaluated with a brachial blood pressure (BP) monitor, echocardiogram and Portapres to measure digital BP, heart rate, cardiac output, stroke volume, and peripheral resistance. Mean values were compared at each HD hour during the first 3 h of a 4-h HD session. The HD characteristics, including Kt/V, were similar for both UFR profiles. Relative blood volume decreased more gradually and linearly with the iUFR. Hemodynamic variables were not significantly different between the two profiles, but brachial BP was more stable with the iUFR. Digital diastolic BP increased with both profiles. Peripheral resistance increased with both profiles, and tended to increase more with the iUFR. Echocardiographic variables changed similarly during the HD session with both profiles. In conclusion, these two UFR profiles are similar in most hemodynamic variables. The statistical equivalence of both profiles suggests that either could be prescribed based on the clinical characteristics of the patient.
authors.affiliation: Departamento de Nefrología, Instituto Nacional de Cardiología Ignacio Chávez, México City, México.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Morales-Alvarez
authors.affiliation: Departamento de Instrumentación Electromecánica, Instituto Nacional de Cardiología Ignacio Chávez, México City, México.
authors.forename: Raúl
authors.initials: R
authors.lastname: Martínez-Memije
authors.affiliation: Departamento de Instrumentación Electromecánica, Instituto Nacional de Cardiología Ignacio Chávez, México City, México.
authors.forename: Brayans
authors.initials: B
authors.lastname: Becerra-Luna
authors.affiliation: Departamento de Instrumentación Electromecánica, Instituto Nacional de Cardiología Ignacio Chávez, México City, México.
authors.forename: Paola
authors.initials: P
authors.lastname: García-Paz
authors.affiliation: Departamento de Instrumentación Electromecánica, Instituto Nacional de Cardiología Ignacio Chávez, México City, México.
authors.forename: Oscar
authors.initials: O
authors.lastname: Infante
authors.affiliation: Departamento de Nefrología, Instituto Nacional de Cardiología Ignacio Chávez, México City, México.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Palma-Ramírez
authors.affiliation: Departamento de Nefrología, Instituto Nacional de Cardiología Ignacio Chávez, México City, México.
authors.forename: Amaya
authors.initials: A
authors.lastname: Caviedes-Aramburu
authors.affiliation: Dirección de Investigación, Instituto Nacional de Cardiología Ignacio Chávez, México City, México.
authors.forename: Jesús
authors.initials: J
authors.lastname: Vargas-Barrón
authors.affiliation: Departamento de Instrumentación Electromecánica, Instituto Nacional de Cardiología Ignacio Chávez, México City, México.
authors.forename: Claudia
authors.initials: C
authors.lastname: Lerma
authors.affiliation: Departamento de Nefrología, Instituto Nacional de Cardiología Ignacio Chávez, México City, México.
authors.forename: Héctor
authors.initials: H
authors.lastname: Pérez-Grovas
mesh_terms: D000328:Adult; D001794:Blood Pressure; D002302:Cardiac Output; D005260:Female; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D008297:Male; D006435:Renal Dialysis / Q000379:methods*; D014462:Ultrafiltration / Q000379:methods*; D055815:Young Adult
keywords: Blood pressure; Hemodialysis; Hemodynamic instability; Ultrafiltration