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Pilot feasibility study examining the effects of a comprehensive volume reduction protocol on hydration status and blood pressure in hemodialysis patients
- Source :
- Hemodialysis international. International Symposium on Home HemodialysisREFERENCES. 24(3)
- Publication Year :
- 2020
-
Abstract
- INTRODUCTION Chronic volume overload is a persistent problem in hemodialysis (HD) patients. The purpose of this study was to investigate the impacts of comprehensive volume reduction protocol on HD patient's hydration status and blood pressure (BP). METHODS Twenty-three HD patients (age = 55.7 ± 13.3 years) completed a 6-month comprehensive volume control protocol consisting of: reducing postdialysis weight; reducing BP medication prescriptions; and weekly intradialytic counseling to reduce dietary sodium intake and interdialytic weight gain (IDWG). The primary outcome was volume overload (VO) measured by bioelectrical impedance spectroscopy. Secondary outcomes included: IDWG, postdialysis weight, estimated dry weight (EDW), dietary sodium intake, BP and BP medication prescriptions. FINDINGS From baseline (0M) to 6 months (6M), significant improvements were noted in: VO (0M 3.9 ± 3.9 L vs. 6M 2.6 ± 3.4 L, P = 0.003), postdialysis weight (0M 89.4 ± 23.1 kg vs. 6M 87.6 ± 22.2 kg; P = 0.012), and EDW (0M 89.0 ± 23.2 vs. 6M 86.7 ± 22.5 kg., P = 0.009). There was also a trend for a reduction in monthly averaged IDWG (P = 0.053), and sodium intake (0M 2.9 ± 1.6 vs. 6M 2.3 ± 1.1 g/d, P = 0.125). Neither systolic BP (0M 162 ± 27 vs. 6M 157 ± 23 mmHg, P = 0.405) nor diastolic BP (0M 82 ± 21 vs. 6M 82 ± 19 mmHg, P = 0.960) changed, though there was a significant reduction in the total number of BP medications prescribed (0M 3.0 ± 1.0 vs. 6M 1.5 ± 1.0 BP meds; P = 0.004). DISCUSSION Our volume reduction protocol significantly improved HD patient's hydration status. While BP did not change, the reduction in prescribed BP medication number suggests improved BP control. Despite these overall positive findings, the magnitude of change in most variables was modest. Comprehensive changes in HD clinics may be necessary to realize more clinically significant results.
- Subjects :
- Adult
Male
medicine.medical_specialty
medicine.medical_treatment
030232 urology & nephrology
Diastole
Volume overload
Blood Pressure
Pilot Projects
030204 cardiovascular system & hematology
Weight Gain
03 medical and health sciences
Young Adult
0302 clinical medicine
Renal Dialysis
Internal medicine
Medicine
Volume reduction
Humans
Hydration status
Aged
Aged, 80 and over
business.industry
Dietary sodium intake
Hematology
Middle Aged
Blood pressure
Nephrology
Cardiology
Feasibility Studies
Kidney Failure, Chronic
Female
Hemodialysis
medicine.symptom
business
Weight gain
Subjects
Details
- ISSN :
- 15424758
- Volume :
- 24
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Hemodialysis international. International Symposium on Home HemodialysisREFERENCES
- Accession number :
- edsair.doi.dedup.....b2cf2dfeb0b77bb6f679063cce0cd74e