title: Isonatric Dialysis Biofeedback in Hemodiafiltration with Online Regeneration of Ultrafiltrate in Hypertensive Hemodialysis Patients: A Randomized Controlled Study.
abstract: Dialysis biofeedback in hemodiafiltration with online regeneration of ultrafiltrate (HFR) could help to improve arterial hypertension. We evaluated the impact of isonatric HFR (HFR-iso) on hypertension control compared to conventional HFR. Forty-seven hemodialysis patients were included and randomized (ratio 2/1) HFR-iso versus HFR during 24 dialysis sessions. In the HFR-iso group (32 patients, 768 dialysis sessions), the predialytic systolic blood pressure (BP) decreased from S1 to S24 of 9 ± 20 mm Hg and increased of 5 ± 24 mm Hg in the HFR group (15 patients, 360 dialysis sessions), variation that differed between the 2 groups (x0394;S1-S24, p = 0.035; interaction group*time, p = 0.012). The diastolic BP (HFR-iso -3 ± 14 mm Hg vs. HFR 5 ± 13 mm Hg; p = 0.088), the DDD of antihypertensive treatment and the dry weight did not vary significantly during the study. Number of sessions complicated by symptomatic hypotension was similar in the 2 groups. HFR-iso improved BP control without increasing dialysis hypotension episodes.
  
  
  OBJECTIVE
  In this multicenter, open-label, controlled, randomized study, we evaluated the impact of dialysis biofeedback in HFR on arterial hypertension compared to conventional HFR. We observed that HFR-iso improved arterial BP control without increasing dialysis hypotension episodes.
authors.affiliation: Biostatistics CHU Pitix00E9;-Salpx00EA;trix00E8;re Paris, Paris, France.
authors.forename: Louise
authors.initials: L
authors.lastname: Chevalier
authors.forename: Christian
authors.initials: C
authors.lastname: Tielemans
authors.forename: Frederic
authors.initials: F
authors.lastname: Debelle
authors.forename: Dominique
authors.initials: D
authors.lastname: Vandervelde
authors.forename: Christine
authors.initials: C
authors.lastname: Fumeron
authors.forename: Lise
authors.initials: L
authors.lastname: Mandart
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Stolear
authors.forename: Isabelle
authors.initials: I
authors.lastname: Simon
authors.forename: Yahsou
authors.initials: Y
authors.lastname: Delmas
authors.forename: Angelo
authors.initials: A
authors.lastname: Testa
authors.forename: Olivier
authors.initials: O
authors.lastname: Mat
authors.forename: Sophie
authors.initials: S
authors.lastname: Tezenas du Montcel
authors.forename: Lucile
authors.initials: L
authors.lastname: Mercadal
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D005260:Female; D005440:Fluid Therapy; D017583:Hemodiafiltration; D015312:Hemodialysis Solutions / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000473:pathology / Q000628:therapy*; D007022:Hypotension / Q000175:diagnosis / Q000503:physiopathology; D007674:Kidney Diseases / Q000097:blood / Q000150:complications / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D012964:Sodium / Q000627:therapeutic use
chemical_list: D000959:Antihypertensive Agents; D015312:Hemodialysis Solutions; D012964:Sodium