Trial reportAmerican journal of nephrology2013
Dialysis dose and intradialytic hypotension: results from the HEMO study.
Trial report in American journal of nephrology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Pooled it
- Dialysate temperature reduction for intradialytic hypotension for people with chronic kidney disease requiring haemodialysis.The Cochrane database of systematic reviews · 2019Pooled it
- The Prevalence of Intradialytic Hypotension in Patients on Conventional Hemodialysis: A Systematic Review with Meta-Analysis.American journal of nephrology · 2019Pooled it
- Antidepressants for treating depression in adults with end-stage kidney disease treated with dialysis.The Cochrane database of systematic reviews · 2016Pooled it
- 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
- Impact of extracorporeal blood flow rate on blood pressure, pulse rate and cardiac output during haemodialysis.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2015Trial
- Association of Calcium Channel Blocker Use With Intradialytic Hypotension in Maintenance Hemodialysis.Kidney international reports · 2024Article
- Real-time prediction of intradialytic hypotension using machine learning and cloud computing infrastructure.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2023Article
- An update review on hemodynamic instability in renal replacement therapy patients.International urology and nephrology · 2023Review
- Prevention of Intradialytic Hypotension in Hemodialysis Patients: Current Challenges and Future Prospects.International journal of nephrology and renovascular disease · 2023Review
- Hemodynamic Tolerance of Virtual Reality Intradialysis Exercise Performed during the Last 30 Minutes versus the Beginning of the Hemodialysis Session.Healthcare (Basel, Switzerland) · 2022Article
- Seasonal variation and predictors of intradialytic blood pressure decline: a retrospective cohort study.Hypertension research : official journal of the Japanese Society of Hypertension · 2021Article
- Serum sodium variation is a major determinant of peridialytic blood pressure trends in haemodialysis outpatients.Scientific reports · 2021Article
- Mechanisms for hemodynamic instability related to renal replacement therapy: a narrative review.Intensive care medicine · 2019Review
- Association of Dose and Frequency on the Survival of Patients on Maintenance of Hemodialysis in China: A Kaplan-Meier and Cox-Proportional Hazard Model Analysis.Medical science monitor : international medical journal of experimental and clinical research · 2018Article
- Osmolality and blood pressure stability during hemodialysis.Seminars in dialysis · 2017Review
- Pathophysiology and implications of intradialytic hypertension.Current opinion in nephrology and hypertension · 2017Review
- French patients on daily hemodialysis: clinical characteristics and treatment trajectories.BMC nephrology · 2016Article
- Prevalence of intradialytic hypotension, clinical symptoms and nursing interventions--a three-months, prospective study of 3818 haemodialysis sessions.BMC nephrology · 2016Observational
- [Intradialytic arterial hypotension in a patient on chronic hemodialysis revealing ante-hypophyseal insufficiency].The Pan African medical journal · 2016Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
backgroundIntradialytic hypotension (IDH) is common and is associated with increased morbidity and mortality in chronic hemodialysis patients. A higher dialysis 'dose' may generate transient intradialytic osmotic gradients, predisposing to intracellular fluid shifts and resulting in hypotension. STUDY
designWe performed a post hoc analysis of the HEMO study, a multicenter trial that randomized chronic hemodialysis patients to high versus standard Kt/V and higher versus lower membrane flux. In order to achieve dose targets, per protocol, adjustments were made in membrane efficiency, blood flow or dialysate flow before changing session length. Detailed hemodynamic and urea kinetic modeling data were abstracted from 1,825 individuals. The primary outcome was the occurrence of hypotensive events necessitating clinical intervention (saline infusion, lowering of ultrafiltration rate or reduced blood flow).
resultsIntradialytic hypotensive events occurred more frequently in the higher-Kt/V group (18.3 vs. 16.8%; p < 0.001). Participants randomized to higher-target Kt/V had a greater adjusted risk of IDH than those randomized to standard Kt/V [odds ratio (OR) 1.12; 95% confidence interval (CI) 1.01-1.25]. Higher vs. lower dialyzer mass transfer-area coefficient for urea and rate of urea removal were associated with greater adjusted odds of IDH (OR 1.15; 95% CI 1.04-1.27 and OR 1.05; 95% CI 1.04-1.06 per mg/dl/h, respectively).
conclusionsHigher dialysis dose, at relatively constrained treatment times, may associate with an increased risk of IDH. These findings support the possibility that rapidity of intradialytic reductions in plasma osmolality may play an important role in mediating hemodynamic instability during dialysis.
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