An update review on hemodynamic instability in renal replacement therapy patients

Yıldız, Abdullah Burak; Vehbi, Sezan; Covic, Andreea; Burlacu, Alexandru; Covic, Adrian; Kanbay, Mehmet

doi:10.1007/s11255-022-03389-w

Cited by 10 publications

(5 citation statements)

References 129 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Die CRRT ist das bevorzugte Verfahren im Kontext hämodynamischer Instabilität. Aus technischer und physikalischer Sicht ist das plausibel: Der Beitrag der CRRT zur hämodynamischen Stabilität basiert auf 12 ……”

Section: Wahl Des Dialyseverfahrensunclassified

Nierenersatztherapie auf Intensivstation

Herrmann,

Reshetnik

2024

Nephrologie aktuell

View full text Add to dashboard Cite

ZUSAMMENFASSUNGBei intensivstationär behandelten Patient*innen kommt es regelmäßig zu akuten Nierenfunktionseinschränkungen (AKI), die oft auch den Einsatz apparativer Nierenersatzverfahren nötig machen. Der vorliegende Artikel soll ein verständliches und umfassendes Kompendium des aktuellen Therapiestandards für Nierenersatzverfahren im intensivstationären Kontext mit der Erläuterung der jeweiligen Evidenz darstellen: So werden die verschiedenen verfügbaren Modalitäten (kontinuierliche versus intermittierende Hämodialyseverfahren sowie Peritonealdialyse) vorgestellt und ihre jeweiligen Vor- und Nachteile diskutiert. Dabei wird auch auf die richtigen Bedingungen für eine etwaige Umstellung von kontinuierlichen auf diskontinuierliche Verfahren eingegangen und der damit in Zusammenhang stehenden Problematik der hämodynamischen Instabilität unter einer Nierenersatztherapie. Weiterhin wird die viel diskutierte Frage nach dem richtigen Zeitpunkt des Beginns von Nierenersatzverfahren im Licht der vorhandenen Evidenz kritisch beleuchtet, genauso wie die Frage nach den Voraussetzungen für eine erfolgreiche Beendigung der Nierenersatztherapie. Verschiedene Antikoagulationsstrategien werden vorgestellt, mit besonderem Augenmerk auf die regionale Antikoagulation mit Zitrat, die mittlerweile die bevorzugte Option insbesondere für kontinuierliche Verfahren darstellt. Ebenso wird auf die Bestimmung der adäquaten Dosen je nach Modalität für den/die einzelne/n Patient*in eingegangen. Auch den spezifischen Aspekten von chronischen Dialysepatient*innen auf Intensivstation wird Rechnung getragen.

show abstract

Section: Wahl Des Dialyseverfahrensunclassified

Nierenersatztherapie auf Intensivstation

Herrmann,

Reshetnik

2024

Nephrologie aktuell

View full text Add to dashboard Cite

show abstract

“…Throughout the hemodialysis procedure, hemodynamic parameters can present significant clinical variations and generate adverse effects. Hemodynamic instability during hemodialysis can occur in some patients and is a recognized potential complication of the procedure 13 . Hemodynamic complications are associated with different factors, including changes in fluid and electrolyte balance, alterations in cardiac function, and hypotension 13 .…”

Section: Introductionmentioning

confidence: 99%

“…Durante o procedimento de hemodiálise, os parâmetros hemodinâmicos podem apresentar variações clínicas significativas e gerar efeitos adversos. A instabilidade hemodinâmica durante a hemodiálise pode ocorrer em alguns pacientes e é uma possível complicação reconhecida do procedimento 13 . As complicações hemodinâmicas estão associadas a diferentes fatores, incluindo alterações no equilíbrio hídrico e eletrolítico, alterações na função cardíaca e hipotensão 13 .…”

Section: Introductionunclassified

Safety and feasibility of transcranial direct current stimulation in end-stage renal disease patients undergoing hemodialysis: an exploratory study

Pegado,

Melo,

Oehmen

et al. 2024

Braz. J. Nephrol.

View full text Add to dashboard Cite

Introduction: Patients with end-stage renal disease often face a challenging routine of hemodialysis, dietary restrictions, and multiple medications, which can affect their hemodynamic function. Home-based, safe, and nonpharmacological approaches such as transcranial direct current stimulation (tDCS) should be combined with conventional treatment. Objective: To assess the safety and feasibility of tDCS on blood pressure and heart rate in patients with end-stage renal disease undergoing hemodialysis. Method: This is a parallel, randomized, sham-controlled trial. Patients undergoing hemodialysis for more than three months were included. The patients received ten non-consecutive 2mA tDCS sessions on the primary motor cortex . Each session lasted 20 minutes. At baseline and after each of the ten sessions, blood pressure and heart rate of the patients were measured hourly for four hours. Results: Thirty patients were randomized to the active or sham group. The mean difference between the groups was calculated as the mean value of the sham group minus the mean value of the active group. Despite there were no statistical changes for all outcomes considering all 10 sessions, we found differences between groups for systolic –10.93 (–29.1;7.2), diastolic –3.63 (–12.4; 5.1), and mean blood pressure –6.0 (–16.3; 4.2) and hear rate 2.26 (–2.5; 7.1). No serious adverse events were found. The active group showed higher blood pressure values at all points, while heart rate was lower in the active group. Conclusion: tDCS is safe and feasible for patients with end-stage renal disease undergoing hemodialysis. Future studies should investigate whether tDCS could potentially induce a hypotensive protective effect during hemodialysis.

show abstract

“…Indeed, older adults with kidney failure are a complex population often presenting multiple chronic diseases and a higher risk of premature mortality (Hirst et al, 2021). Hemodialysis (HD), which is the most prevalent modality of renal replacement therapy, occurs thrice weekly and comes with adverse side effects both during and after treatment (Almutary et al, 2013;Yildiz et al, 2023).…”

Section: Introductionmentioning

confidence: 99%

“…Interestingly, aerobic intradialytic exercise (IDE) has been shown to be beneficial, among others, in improving physical and psychological dimensions of HRQoL, functional capacity, fatigue levels, blood pressure management and systemic inflammation (Araujo et al, 2022;Hu et al, 2022;Intiso, 2014;Meléndez Oliva et al, 2022;Pu et al, 2019). IDE is also considered as a promising strategy for a better blood pressure control during and 24 hours after HD treatment and is recognized to reduce hemodynamic instability as well as incidence and severity of IDH (Kim et al, 2019;Mcguire et al, 2018;Yildiz et al, 2023). However, fundamental knowledge regarding the underlying mechanisms responsible for the benefits of IDE remains highly incomplete (Neufer et al, 2015;Sanford et al, 2020).…”

Section: Introductionmentioning

confidence: 99%