Can extracellular fluid volume expansion in hemodialysis patients be safely reduced using the hemocontrol biofeedback algorithm? A randomized trial.

Full Abstract

Extracellular fluid volume (ECFV) expansion in hemodialysis patients is associated with increased mortality. Attempts to remove excess fluid often result in intradialytic hypotension (IDH). Blood volume monitoring has been used to aid selection of ultrafiltration rates and dialysate conductivity to minimize IDH. Automating ultrafiltration and dialysate conductivity using the Hemocontrol Biofeedback System (HBS) has reduced IDH in IDH-prone subjects. We undertook a randomized controlled trial to determine if the HBS could safely reduce ECFV in ECF-expanded subjects. Patients with ECFV >45% of total body water were randomized to receive hemodialysis by either HBS or best clinical practices for 6 months. The primary endpoint was change in ECFV; exploratory variables included frequency of IDH, interdialytic weight gain, and changes in serum Na. Treatment with HBS did not result in any change in ECFV, even after multivariable adjustment. The frequency of IDH was however significantly lower with HBS when compared with best clinical practices without differences in other variables.

Learn Faster Today Improve your study skills

Author information

Author/s: Nesrallah, Gihad E (GE); Suri, Rita S (RS); Thiessen-Philbrook, Heather (H); Heidenheim, Paul (P); Lindsay, Robert M (RM);

Affiliation: Department of Nephrology, Humber River Regional Hospital, Toronto, Canada.

Journal and publication information

Publication Type: Journal Article; Randomized Controlled Trial

Journal: ASAIO journal (American Society for Artificial Internal Organs : 1992) (ASAIO J), published in United States. (Language: eng)

Reference: -2008 May-Jun; vol 54 (issue 3) : pp 270-4

Dates: Created 2008/05/22; Completed 2008/07/03;

PMID: 18496276, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article (including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.

MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Aged
Algorithms
Biofeedback (Psychology) - methods
Blood Volume
Extracellular Fluid - physiology
Female

Hemodynamics
Humans
Hypotension - etiology; prevention & control
Male
Middle Aged
Renal Dialysis - adverse effects; methods; statistics & numerical data

These are the highest related articles currently in the database:

See 100+ related articles.