Blood Pressure Control and Hemodynamic Changes in Patients on Long Time Dialysis Treatment

Luik, A. J.; Charra, Bernard; Katzarski, Krassimir; Habets, Jos; Cheriex, Emile C.; Menheere, P. P. C. A.; Laurent, Guy; Bergström, Jonas; Leunissen, Karel M.L.

doi:10.1159/000014335

Cited by 51 publications

(40 citation statements)

References 40 publications

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“…[7][8][9] Hemodynamic changes accompanying to the ultrafiltration performed to prevent hypervolemia are also among well-studied subjects. [10][11][12][13] Also in our study, with a mean amount of ultrafiltration of 2.49 ± 0.83 L performed, significant reduction was observed in post-dialysis systolic blood pressure, diastolic blood pressure and mean arterial blood pressure (113.20 ± 18.57 mmHg, 68.05 ± 11.82 mmHg, 83.10 ± 13.34, respectively) compared to pre-dialysis systolic blood pressure, diastolic blood pressure and mean arterial blood pressure (132.43 ± 17.30 mmHg, 77.10 ± 9.66 mmHg and 95.54 ± 11.41, respectively). Namely, there is a negative significant correlation between ultrafiltration and blood pressure measurements (p50.01).…”

Section: Discussionmentioning

confidence: 99%

Objective analysis of voice changes in a hemodialysis session and its correlation with ultrafiltration

Ünver

Hardal

Esertas³

et al. 2014

Renal Failure

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Introduction: The aim of the study is to analyze the voice changes occurring during a hemodialysis session objectively and to investigate the statistical correlation between voice changes and ultrafiltration, blood pressure, dry weight and the other variables of the patients. Materials and methods: A total of 169 patients were included in the study. Electronic voice recordings of the patients were performed with the aim of making objective voice analysis before and after dialysis. Fundamental frequency measurements occurring at the level of the larynx (Fo) and harmonic-to-noise ratio (HNR) were measured from these voice recordings. Results: When the voice recordings obtained from 169 hemodialysis patients before and after dialysis were investigated, it was observed that a significant increase occurred in the Fo (from 164.52 ± 43.36 Hz to 193.19 ± 47.08 Hz, p50.01). When the change in HNR was investigated, a significant reduction was determined in the post-dialysis measurements (4.6 ± 3.23 dB) compared to the pre-dialysis measurements (16.10 ± 4.06 dB, p50.01). Mean 2.49 ± 0.83 L of ultrafiltration was performed and a significant reduction was observed in post-session body weights of the patients (p5 0.01). There was a highly statistical significance between the measurements of post-dialysis Fo and post-dialysis body weights. A highly significant correlation was determined between the amount of ultrafiltration performed and a significant increase observed in Fo before and after dialysis. Also a significant correlation was determined between the reduction in the mean post-session blood pressures and the reduction in the HNRs. Conclusion: Objective voice analysis is suggesting that it can be a simple and applicable method that can be used to determine the dry weight.

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Section: Discussionmentioning

confidence: 99%

Objective analysis of voice changes in a hemodialysis session and its correlation with ultrafiltration

Ünver

Hardal

Esertas³

et al. 2014

Renal Failure

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“…It has been shown that in salt-sensitive patients, volume control alone fails to reduce blood pressure or left ventricular hypertrophy associated with hypertension, [12][13][14] while the reduction of the dialysate Na concentration combined with dietary salt restriction over several weeks may result in a decrease in the blood pressure, without additional changes in the dry weight. [15] Moreover, it was shown that the volume removal during dialysis is not significantly affected by changes in the dialysis Na concentration.…”

Section: Discussionmentioning

confidence: 99%

Blood Pressure and Heart Rate Variability in Patients on Conventional or Sodium-Profiling Hemodialysis

et al. 2008

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Background. Autonomic nervous system dysfunction and dialysate sodium (Na) concentration are believed to play a role in the pathogenesis of hemodialysis-related hypertension. The present study was undertaken to determine whether increases in blood pressure in hemodialysis patients are associated with changes in heart rate variability (HRV), a measure of the autonomic nervous system function, and long-term exposure to increased dialysate Na concentration. Methods. Baseline clinical, biochemical data and HRV of patients undergoing increased Na profiling dialysis (High-Na, n = 9) and on conventional treatment (Control, n = 11) were compared with those obtained after one year of study. Results. After one year, the mean predialysis systolic blood pressure (SBP) increased in seven patients of the High-Na and in five of the Control group, and decreased or remained unchanged in the remaining subjects. Initial HRV was significantly higher in patients with increased SBP, and it increased further in these patients after one year. At the end of the study, post-dialysis plasma Na, osmolality, and weight gains were significantly higher in the High-Na group. No significant correlation, however, was found between individual changes in intradialytic sodium elimination and the alterations in blood pressure. Conclusion. These data suggest that the dialysate sodium concentration, a most important determinant of interdialytic weight gain and fluid balance, is only partly correlated with longterm changes in blood pressure. An increased blood pressure over time may develop in a subset of hemodialysis patients with higher HRV, suggestive of increased sympathetic activity.

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“…Measures that are used to determine dry weight include: clinical parameters, especially hypotension or muscle cramps at the end of dialysis [1], normotension at the beginning of dialysis [2,3,4], plasma atrial natriuretic polypeptide (ANP) and cyclic guanosine monophosphate (cGMP) [5], echocardiographic measurement of the inferior vena cava diameter after dialysis [6], and conductivity methods (bioimpedance) [7]. None of these methods seems to be accurate enough [1, 8].…”

Section: Introductionmentioning

confidence: 99%

Effect of Hemodialysis on the Thickness of Vocal Folds: A Possible Explanation for Postdialysis Hoarseness

Ori¹,

Sabo²,

Binder³

et al. 2006

Nephron Clin Pract

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Background: Determining the dry weight of chronically hemodialysed patients is a common problem. Patients on intermittent hemodialysis often experience transient hoarseness at the end of dialysis. The vocal folds may be affected by the hydration state. Aim: To test the hypothesis that postdialysis hoarseness may be related to changes in the thickness of the vocal folds. Methods: Twenty-five stable chronic hemodialysis patients underwent endoscopic nasopharyngeal laryngoscopy before and after dialysis. Pictures of the vocal folds were taken and the folds were measured using computer software. Eighteen vocal folds from 16 patients were technically adequate for analysis. The change in the width/length ratio of the vocal folds (W/L) was used as a measurement of the folds’ thickness. Results: W/L decreased from 0.175 ± 0.011 before dialysis to 0.152 ± 0.009 after dialysis (p < 0.01, mean reduction 10.9 ± 3.8%). Patients’ weight decreased by 4.7 ± 0.3% (p < 0.0001), systolic blood pressure decreased by 15.0 ± 3.1% (p < 0.001), diastolic blood pressure decreased by 13.0 ± 3.6% (p < 0.01), and mean blood pressure decreased by 14.1 ± 3.1% (p < 0.001). Sixty percent of the patients had postdialysis hoarseness, and in 72% of the patients a decrease in the vocal folds’ thickness was observed. Conclusions: Chronic hemodialysis patients may experience transient postdialysis hoarseness, and a decrease in the vocal folds’ thickness. The latter may result from dehydration.

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Blood Pressure Control and Hemodynamic Changes in Patients on Long Time Dialysis Treatment

Cited by 51 publications

References 40 publications

Objective analysis of voice changes in a hemodialysis session and its correlation with ultrafiltration

Objective analysis of voice changes in a hemodialysis session and its correlation with ultrafiltration

Blood Pressure and Heart Rate Variability in Patients on Conventional or Sodium-Profiling Hemodialysis

Effect of Hemodialysis on the Thickness of Vocal Folds: A Possible Explanation for Postdialysis Hoarseness

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