ArticleAmerican journal of nephrology2012
Preservation of blood pressure stability with hypertonic mannitol during hemodialysis initiation.
Article in American journal of nephrology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- A randomized controlled trial of two dialysate sodium concentrations in hospitalized hemodialysis patients.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2022Trial
- A randomized trial of albumin infusion to prevent intradialytic hypotension in hospitalized hypoalbuminemic patients.Critical care (London, England) · 2021Trial
- Hypertonic Mannitol for the Prevention of Intradialytic Hypotension: A Randomized Controlled Trial.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2019Trial
- Study protocol for a single-blind, placebo-controlled randomised trial of Tianjiu effects in patients with intradialytic hypotension.BMJ open · 2016Trial
- Dialysis dose and intradialytic hypotension: results from the HEMO study.American journal of nephrology · 2013Trial
- A Narrative Summary of Strategies to Mitigate Intradialytic Hypotension in Poisoned Patients Requiring Extracorporeal Toxin Elimination.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2026Review
- An update review on hemodynamic instability in renal replacement therapy patients.International urology and nephrology · 2023Review
- Metabolites Potentiate Nitrofurans in Nongrowing Escherichia coli.Antimicrobial agents and chemotherapy · 2021Article
- An update review of intradialytic hypotension: concept, risk factors, clinical implications and management.Clinical kidney journal · 2020Review
- Mechanisms for hemodynamic instability related to renal replacement therapy: a narrative review.Intensive care medicine · 2019Review
- Osmolality and blood pressure stability during hemodialysis.Seminars in dialysis · 2017Review
- Association of Predialysis Calculated Plasma Osmolarity With Intradialytic Blood Pressure Decline.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2015Article
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Authors and funding
4 authors.
Funding
Abstract
backgroundIntradialytic hypotensive events are common among hemodialysis patients and are associated with a variety of patient- and procedure-related factors, including intradialytic decline in plasma osmolality. Prior studies and practice have suggested that administration of osmotically active drugs may ameliorate blood pressure decline during chronic hemodialysis.
methodsClinical and treatment data were collected for 102 consecutive patients requiring initiation of renal replacement therapy in 2 major teaching hospitals. Routine administration of mannitol differed according to institutional protocols, allowing its examination as the primary exposure of interest. Generalized linear models were fit to estimate associations of mannitol use during dialysis initiation with intradialytic blood pressure, as assessed by: (1) intradialytic blood pressure decline; (2) nadir intradialytic blood pressure; (3) absolute systolic blood pressure <90 mm Hg or decline >20 mm Hg.
resultsMean age was 62 years (±16), 70% were male and 44% were diabetic. Mean predialysis and nadir systolic blood pressure were 142 mm Hg (±29) and 121 mm Hg (±26), respectively. Mannitol administration was associated with a lesser decline in intradialytic blood pressure, a higher nadir blood pressure and fewer hypotensive events requiring intervention. No effect modification was evident according to diabetes or acuity of kidney disease (chronic vs. acute).
conclusionsMannitol administration appears to preserve hemodynamic stability during hemodialysis initiation. Randomized controlled trials are needed to confirm these findings and identify optimal management strategies to prevent intradialytic hypotension.
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