2017
DOI: 10.1007/s11897-017-0356-6
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Volume Balance and Intradialytic Ultrafiltration Rate in the Hemodialysis Patient

Abstract: PURPOSE OF REVIEW Volume management in hemodialysis patients is often challenging. Assessing volume status and deciding how much fluid to remove during hemodialysis, the so-called ultrafiltration rate (UFR), has remained a conundrum. RECENT FINDINGS To date there is no objective assessment tool to determine the needed UFR during each hemodialysis session. Higher volume overload or higher UFR is associated with poor outcomes including worse mortality and unfavorable clinical outcomes. We suggest combined use … Show more

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Cited by 37 publications
(32 citation statements)
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“…A core group made up of nurses and physicians conducted a series of meetings to develop the decision aid, which was based on empirical experience and a literature review identifying and appraising physiological parameters routinely measured in haemodialysis care for assessment of fluid status (Wizemann & Schilling ; Kraemer ; Lindley et al . ; Chou & Kalantar‐Zadeh ). For review and evaluation of the content and comprehensiveness, the tool was then circulated to a larger group of interdisciplinary stakeholders, and experts in the use of BIS, including clinical scientists, dieticians, physiotherapists and physicians, and also to patients’ representatives.…”
Section: Methodsmentioning
confidence: 99%
See 1 more Smart Citation
“…A core group made up of nurses and physicians conducted a series of meetings to develop the decision aid, which was based on empirical experience and a literature review identifying and appraising physiological parameters routinely measured in haemodialysis care for assessment of fluid status (Wizemann & Schilling ; Kraemer ; Lindley et al . ; Chou & Kalantar‐Zadeh ). For review and evaluation of the content and comprehensiveness, the tool was then circulated to a larger group of interdisciplinary stakeholders, and experts in the use of BIS, including clinical scientists, dieticians, physiotherapists and physicians, and also to patients’ representatives.…”
Section: Methodsmentioning
confidence: 99%
“…Current fluid management in haemodialysis is mainly based on clinical assessment, such as weight gain between dialysis sessions, pre‐ and post‐dialysis blood pressure (BP) and patient‐reported symptoms (Lindley et al . ; Chou & Kalantar‐Zadeh ). However, it is not always straightforward.…”
Section: Introductionmentioning
confidence: 99%
“…During dialysis, patients should be monitored for signs that too much fluid has been removed, or that ultrafiltration has been done too rapidly. These signs include not only hypotension, but also tachycardia, lightheadedness, muscle cramps, and loss of appetite (Chou and Kalantar-Zadeh, 2017;Kalantar-Zadeh et al, 2009). When changes to the ultrafiltration goal are made, the patient's symptoms should be reassessed to determine whether an adequate dry weight has been achieved.…”
Section: Management Of Volume Status With Dialysismentioning
confidence: 99%
“…3 This device is comprised of an air pump machine and either sleeves or boots that have separate compartments that inflate sequentially; commonly cycles of compression and decompression are used with the goal of generating pressure gradients along tissue with a subsequent increase of blood flow and venous return, 4,5 hence it is an emerging tool for palliative intervention in patients with endstage renal disease (ESRD) while receiving hemodialysis (HD). The hemodynamic challenge of HD relies on achieving an adequate volume balance to avoid situations in which patients are over or under dialyzed 6 resulting in further complications like intradialytic hypotension (IDH), interruption of treatment and significant distress to patients. 7 Currently, about 400,000 adults are on HD in the USA, 8 and it is estimated that IDH occurs in approximately 1 of every 4 treatments and also it is commonly associated with distressing symptoms such as lightheadedness, weakness, muscle cramps, and nausea and vomiting.…”
Section: Introductionmentioning
confidence: 99%