A Study on Regulating Factors of Plasma Refilling during Hemodialysis

Ito, Osamu; Tabei, Kaoru; Nagashima, Hirofumi; Asano, Yoshihide

doi:10.1159/000189276

Cited by 43 publications

(61 citation statements)

References 8 publications

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“…Because adrenergic activity has been reported to decrease filtration coefficients [11], the lack of suppressed filtration coefficients in DM could result from this derangement. However, the total effects of adrenergic activity on plasma refilling are more complex.…”

Section: Discussionmentioning

confidence: 98%

“…month 9 Lp, ml/ mm Hg/ min 10 Vp0 liters 11 Lp/Vp0 Vp0/BW % 12 1 Cause of renal failure: 1 = diabetic nephropathy; 2 = nondiabetic nephropathy.…”

Section: Introductionmentioning

confidence: 99%

“…10 Filtration coefficient. 11 Plasma volume before hemodialysis session. 12 Percentage of plasma volume to body weight before hemodialysis session.…”

Section: Introductionmentioning

confidence: 99%

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Estimation of Filtration Coefficients and Circulating Plasma Volume by Continuously Monitoring Hematocrit during Hemodialysis

et al. 2002

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Background/Aims: Filtration coefficients (Lp) and plasma volume were estimated in order to investigate whether suppressed Lp associates with intradialytic hypotension and/or diabetic nephropathy. Methods: Twenty-one patients were evaluated. Nine patients were diabetic (DM) and 12 were nondiabetic (non-DM). Three of DM and 4 of non-DM were prone to dialysis-induced hypotension (hypo(+)) and others (hypo(–)) were not. Changes in hematocrit (Ht) were measured for 60 min after the start of ultrafiltration. Lp and plasma volume at the start of ultrafiltration (Vp0) were estimated to fit calculating values of Ht based on Schneditz’s open two compartment model to actual value. Results: There was no significant difference in the mean values of Lp/Vp0 either between hypo(+) and hypo(–) (0.87 ± 0.37 vs. 1.24 ± 0.48 ml/mm Hg·min·liter; n.s.) or between DM and non-DM (1.04 ± 0.32 vs. 1.17 ± 0.56 ml/mm Hg·min· liter; n.s.). However, the comparisons of Lp/Vp0 among the four groups (hypo(+)/DM, hypo(–)/DM, hypo(+)/non-DM and hypo(–)/non-DM) showed significant differences between hypo(+)/non-DM and hypo(–)/non-DM (1.08 ± 0.40, 1.02 ± 0.32, 0.71 ± 0.29*, 1.40 ± 0.53* ml/mm Hg·min·liter; *p < 0.05). Differences in the percentage of Vp0 to body weight (Vp0/BW) among four groups and correlation between Lp/Vp0 and Vp0/BW were not significant. Conclusion: These data indicated that reduction of Lp/Vp0 was not simply caused by decreased circulating plasma volume (Vp0/BW) and that the suppressed filtration coefficients may have substantial association with dialysis-induced hypotension in non-DM. The estimation of Lp using in-line measurement of Ht was a useful method for analyzing intradialytic hypotension.

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Section: Discussionmentioning

confidence: 98%

“…month 9 Lp, ml/ mm Hg/ min 10 Vp0 liters 11 Lp/Vp0 Vp0/BW % 12 1 Cause of renal failure: 1 = diabetic nephropathy; 2 = nondiabetic nephropathy.…”

Section: Introductionmentioning

confidence: 99%

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Estimation of Filtration Coefficients and Circulating Plasma Volume by Continuously Monitoring Hematocrit during Hemodialysis

et al. 2002

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“…Plasma AVP levels in patients varied widely, with some studies reporting pre-HD plasma AVP levels above the concentration regarded as the upper level of normal of 4 pg/ml [2,16,24,25,35,37,38,39,40,41,45,46,47,48,49,50,51,52,53,54], while others found pretreatment plasma AVP levels around or below 4 pg/ml [32,33,34,43,44,55,56,57] (fig. 3a).The variation in pretreatment plasma AVP levels might be due to analytical variation resulting from the use of different assays.…”

Section: Plasma Vasopressin Levels In Dialysis Patients and Healthy Imentioning

confidence: 99%

“…Twenty-six of these studies, comprising 496 patients, were eligible for the meta-analysis since these studies reported the mean and standard deviation of plasma AVP levels before and after standard HD. Several studies observed a significant increase in plasma AVP levels during HD [15,16,29,38,52,53,57], whereas the other studies did not [32,33,34,35,36,37,39,40,41,42,43,44,46,49,50,51,54,55,56,58]. Overall, plasma AVP levels showed little or no increase during standard HD (7.0 ± 4.9 and 8.8 ± 9.3 pg/ml for pre- and post-HD, respectively; p = 0.433) .…”

Section: Effect Of Dialysis On Plasma Avp Levelsmentioning

confidence: 99%

Dialysis Hypotension: A Role for Inadequate Increase in Arginine Vasopressin Levels? A Systematic Literature Review and Meta-Analysis

Ettema¹,

Zittema²,

Kuipers

et al. 2014

Am J Nephrol

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Background: Intradialytic hypotension is a common complication of hemodialysis (HD). Some studies have suggested that inadequate arginine vasopressin (AVP) increase could play a role in the pathogenesis of intradialytic hypotension. However, AVP levels during HD and its relation to hypotension has never been systematically studied. Summary: PubMed and Embase were searched (1970-2013, search terms ‘vasopressin' and ‘hemodialysis') for studies reporting on AVP levels during standard HD or other dialysis techniques. Observational studies reporting on AVP levels pre- and postdialysis were additionally included in a meta-analysis. Thirty-seven studies were included in the systematic literature review, of which 26 studies were eligible for meta-analysis. The main findings were that pretreatment AVP levels were higher in dialysis patients compared with healthy controls (6.4 ± 3.5 vs. 2.5 ± 1.3 pg/ml, p = 0.003) and that plasma AVP levels showed little or no increase during HD (from 7.0 ± 4.9 to 8.8 ± 9.3, p = 0.433). Significant heterogeneity was found between studies. Meta-regression analysis revealed no significant associations between AVP and patient or study characteristics. Studies on other dialysis techniques showed mixed results regarding the AVP course. The eight studies that addressed the relation between intradialytic hypotension and AVP also showed inconsistent results. Key Messages: Plasma AVP levels are higher in dialysis patients compared with healthy controls, but show little or no increase during HD. The lack of a rise in AVP levels during HD may be pathophysiologically involved in the onset of intradialytic hypotension, but firm conclusions are not possible from our review of the literature.

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The use of diuretics in heart failure with congestion — a position statement from the Heart Failure Association of the European Society of Cardiology

Mullens

Damman

Harjola

et al. 2019

European J of Heart Fail

780

697

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The vast majority of acute heart failure episodes are characterized by increasing symptoms and signs of congestion with volume overload. The goal of therapy in those patients is the relief of congestion through achieving a state of euvolaemia, mainly through the use of diuretic therapy. The appropriate use of diuretics however remains challenging, especially when worsening renal function, diuretic resistance and electrolyte disturbances occur. This position paper focuses on the use of diuretics in heart failure with congestion. The manuscript addresses frequently encountered challenges, such as (i) evaluation of congestion and clinical euvolaemia, (ii) assessment of diuretic response/resistance in the treatment of acute heart failure, (iii) an approach towards stepped pharmacologic diuretic strategies, based upon diuretic response, and (iv) management of common electrolyte disturbances. Recommendations are made in line with available guidelines, evidence and expert opinion.

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A Study on Regulating Factors of Plasma Refilling during Hemodialysis

Cited by 43 publications

References 8 publications

Estimation of Filtration Coefficients and Circulating Plasma Volume by Continuously Monitoring Hematocrit during Hemodialysis

Estimation of Filtration Coefficients and Circulating Plasma Volume by Continuously Monitoring Hematocrit during Hemodialysis

Dialysis Hypotension: A Role for Inadequate Increase in Arginine Vasopressin Levels? A Systematic Literature Review and Meta-Analysis

The use of diuretics in heart failure with congestion — a position statement from the Heart Failure Association of the European Society of Cardiology

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