1. Association of intradialytic hypotension and convective volume in hemodiafiltration: results from a retrospective cohort study
- Author
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Franklin Mora-Bravo, Alfonso Mariscal Ramírez, Guadalupe De-La-Cruz, Héctor Pérez-Grovas, Jochen G. Raimann, and Sonia Rivera
- Subjects
Adult ,Male ,medicine.medical_specialty ,Blood volume ,Comorbidity ,Hemodiafiltration ,Logistic regression ,lcsh:RC870-923 ,Intradialytic hypotension ,Cohort Studies ,Risk Factors ,Internal medicine ,medicine ,Humans ,Mexico ,Retrospective Studies ,Blood Volume ,Blood Volume Determination ,business.industry ,Convective volume ,Incidence (epidemiology) ,Incidence ,Confounding ,Retrospective cohort study ,Odds ratio ,Middle Aged ,medicine.disease ,lcsh:Diseases of the genitourinary system. Urology ,Causality ,Treatment Outcome ,Nephrology ,Kidney Failure, Chronic ,Female ,Hypotension ,business ,Cohort study ,Research Article - 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.
- Published
- 2012