Trial reportBMC nephrology2017
Blood volume-monitored regulation of ultrafiltration to decrease the dry weight in fluid-overloaded hemodialysis patients: a randomized controlled trial.
Trial report in BMC nephrology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01416753 (A Randomized Controlled Clinical Trial Comparing, in Fluid-Overloaded Hemodialysis Patients, Three Strategies of Fluid Removal), which is not on this map. Cited by 18 papers, 3 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.
A Randomized Controlled Clinical Trial Comparing, in Fluid-Overloaded Hemodialysis Patients, Three Strategies of Fluid Removal: Regulation of Ultrafiltration and Dialysate Conductivity, Regulation of Ultrafiltration and Temperature, and Standard Hemodialysis
Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Comparison of blood volume biofeedback hemodialysis and conventional hemodialysis on cardiovascular stability and blood pressure control in hemodialysis patients: a systematic review and meta-analysis of randomized controlled trials.Journal of nephrology · 2024Pooled it
- Carnitine supplements for people with chronic kidney disease requiring dialysis.The Cochrane database of systematic reviews · 2022Pooled it
- Dialysate temperature reduction for intradialytic hypotension for people with chronic kidney disease requiring haemodialysis.The Cochrane database of systematic reviews · 2019Pooled it
- Implementation of a decision aid for recognition and correction of volume alterations (RecovaUpsala journal of medical sciences · 2020Trial
- Nutritional Challenges in Hemodialysis: A Perspective from Albania.The Eurasian journal of medicine · 2026Article
- Monitoring and maintaining quality in the paediatric haemodialysis unit.Pediatric nephrology (Berlin, Germany) · 2025Review
- Review
- Hypervolemia in Dialysis Patients Impairs STAT3 Signaling and Upregulates miR-142-3p: Effects on IL-10 and IL-6.International journal of molecular sciences · 2024Article
- Bioimpedance-derived euvolemic weight varies in hemodialysis patients-challenging the fixed target weight concept.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2024Article
- The Extracellular Mass to Body Cell Mass Ratio as a Predictor of Mortality Risk in Hemodialysis Patients.Nutrients · 2022Observational
- Sodium First Approach, to Reset Our Mind for Improving Management of Sodium, Water, Volume and Pressure in Hemodialysis Patients, and to Reduce Cardiovascular Burden and Improve Outcomes.Frontiers in nephrology · 2022Review
- Volume overload in hemodialysis: diagnosis, cardiovascular consequences, and management.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2021Review
- Assessing accuracy of estimated dry weight in dialysis patients post transplantation: the kidney knows best.Journal of nephrology · 2021Observational
- Systematic Fluid Assessment in Haemodialysis: Development and Validation of A Decision Aid.Journal of renal care · 2020Article
- Greater fluid overload and lower interdialytic weight gain are independently associated with mortality in a large international hemodialysis population.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2018Article
- 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
- Novel Insights into the Pathogenesis and Prevention of Intradialytic Hypotension.Blood purification · 2018Review
- Fluid and hemodynamic management in hemodialysis patients: challenges and opportunities.Jornal brasileiro de nefrologiaArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBecause chronic fluid volume overload is associated with higher mortality, we tested whether blood-volume monitored regulation of ultrafiltration and dialysate conductivity (UCR) and/or regulation of ultrafiltration and temperature (UTR) would facilitate dry weight reduction, in comparison to conventional dialysis (CONV).
methodsWe carried out a multicenter, 4-week, randomized controlled trial in hemodialysis patients ≥15% above normal extracellular fluid volume (ECV), per bioimpedance spectroscopy, who were randomized 1:1:1. Applying UCR (Nikkiso), UTR (Fresenius) and CONV, initial dry weight was reduced rapidly to target. Dry weight reduction was attenuated and eventually stopped at the occurrence of dialysis complications. The primary outcome was defined as intra- and postdialytic complications. Secondary outcomes were magnitudes of dry weight and blood pressure reduction.
resultsOf 244 patients assessed, N = 95 had volume overload ≥15% above normal ECV. Fifty patients received the allocated interventions (N = 16 UCR, N = 18 UTR, N = 16 CONV) and completed the trial. The rate of complications was significantly lower in UTR compared to CONV (21 ± 21% vs 34 ± 20%, p = 0.022), and also compared to UCR (vs 39 ± 27%, p = 0.028), but not statistically different between UCR and CONV (p = 0.93). Dry weight reduction was significantly higher in UTR compared to UCR (5.0 ± 3.4% vs 2.0 ± 2.7% body weight, p = 0.013), but not compared to CONV (vs 3.9 ± 2.1% body weight, p = 0.31). Systolic blood pressure reduction throughout the intervention phase was 17 ± 22 mmHg overall, but not significantly different between the three groups. Average maximum ultrafiltration rates were significantly higher in UTR than in UCR and CONV, at statistically similar dialysis times. Retrospective examination of randomly selected hemodialysis sessions in the UCR group identified technical mistakes in 36% of the dialysis sessions, despite considerable training efforts.
conclusionsEven in patients with volume overload, fluid removal was challenging. Despite the relative advantage of UTR, which must be interpreted with caution in view of the poor technical execution of UCR, this study renders clear that fluid removal must not be reinforced rapidly. Apprehension of this obstacle is imperative for future clinical and academic endeavors aimed at improving dialysis outcomes by correcting volume status.
trial registrationClinicalTrials.gov ( NCT01416753 ), trial registration date: August 12, 2011.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.