PMID: 18203072Jan 19, 2008Paper

Integration of blood volume, blood pressure, heart rate and bioimpedance monitoring for the achievement of optimal dry body weight during chronic hemodialysis

The International Journal of Artificial Organs
M BonelloClaudio Ronco

Abstract

Achieving optimal dry body weight in hemodialysis is challenging. Clinical assessment alone is inadequate, and methods such as bioimpedance monitoring may be impractical for every patient treatment. Continuous blood volume monitoring, blood pressure and heart rate variability inform clinical decision-making, but integrated use of multiple methodologies to achieve dry weight and understand patient factors has not yet been described. Nineteen chronic hemodialysis patients underwent thrice-weekly treatments for two weeks. Baseline hydration status and target weight were determined by bioimpedance. During subsequent treatments, ultrafiltration was adjusted and relative blood volume, blood pressure and pulse were recorded non-invasively. Bioimpedance was repeated to assess hydration. Response of variables to progressive change in weight was assessed and selected patients underwent additional autonomic function testing. Four distinct hemodynamic patterns emerged. Profile A: 4 patients demonstrated overhydration at baseline. With decreasing target, pulse and blood pressure remained stable while blood volume and bioimpedance demonstrated achievement of dry weight. Profile B: 8 patients demonstrated overhydration at baseline. With decre...Continue Reading

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Citations

Jan 25, 2013·Blood Purification·Claudio Ronco
Jan 24, 2018·Clinical & Experimental Optometry : Journal of the Australian Optometrical Association·Yu ZhangZhiliang Wang
Sep 18, 2009·Hemodialysis International·Niloufar KossariPierre Squara
Apr 21, 2018·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·David F KeaneSue Pavitt
Nov 6, 2009·Hemodialysis International·Lindsay J ChestertonChris W McIntyre

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