ArticleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2018
Systemic haemodynamics in haemodialysis: intradialytic changes and prognostic significance.
Article in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 17 citations in OpenAlex.
- Enhanced external counter pulsation as a novel therapy to maintain cardiac output during hemodialysis: a preliminary randomized controlled study.Scientific reports · 2025Trial
- Differences in circulatory dynamics and skeletal muscle blood flow during exercise between post-dialysis and non-dialysis days in hemodialysis patients.International urology and nephrology · 2026Article
- Effects of Pre-Dialysis Fluid Overload, Intradialytic Relative Blood Volume Levels, and Cumulative Ultrafiltration Volume on Pulse Wave-Derived Features during Hemodialysis: Results from a Longitudinal Cohort Study.Kidney & blood pressure research · 2026Article
- Point-of-Care Ultrasonography in Advanced Nephrology Nursing Practice: Seeing Beyond the Numbers.Diagnostics (Basel, Switzerland) · 2025Review
- Occurrence of benzodiazepines and nonbenzodiazepines usage among newly-onset of peritoneal dialysis versus hemodialysis patients.BMC nephrology · 2025Article
- Changes of Brain Functional Connectivity in End-Stage Renal Disease Patients Receiving Peritoneal Dialysis Without Cognitive Decline.Frontiers in medicine · 2021Article
- Changes in cardiac output with hemodialysis relate to net volume balance and to inferior vena cava ultrasound collapsibility in critically ill patients.Renal failure · 2020Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Although haemodialysis (HD) leads to alterations of systemic haemodynamics that can be monitored using dilution methods, there is a lack of data on the diagnostic and prognostic significance of haemodynamic monitoring during routine HD. Methods: In this multicentre study, we measured cardiac index (CI), access flow (AF) and central blood volume index (CBVI) during a single HD session in stable HD patients (n = 215) using the Transonic HD03 monitor (Transonic, Ithaca, NY, USA). Systemic CI (SCI) was defined as CI corrected for AF. In a subset of patients (n = 82), total end-diastolic volume index (TEDVI) and total ejection fraction (TEF) were derived from dilution curves. Data were correlated with clinical parameters, cardiac biomarkers and bioimpedance measurements (body composition monitor; Fresenius Medical Care, Homburg, Germany). Mortality was assessed prospectively after a median follow-up of 2.6 years. Results: Median CI, CBVI and AF were 2.8 L/min/m2 (interquartile range 2.4-3.4), 15 mL/kg (14.5-15.7) and 980 mL/min (740-1415), respectively, at the beginning of HD. At the end of HD, CI, CBVI and AF significantly fell by -10% (-22 to 3, P < 0.0001), -9% (-23 to 3, P < 0.0001) and -4% (-13 to 5, P = 0.0004), respectively. Peripheral resistance (PR) increased slightly (P = 0.01) and blood pressure fell by -6/-3 mmHg to 128/63 mmHg (P < 0.0001). Independent predictors of ΔCI were age and ultrafiltration rate, whereas AF, overhydration and PR were protective. TEF was strongly associated with mortality [area under the dilution curve 0.77, P < 0.0001], followed by TEDVI (0.72, P = 0.0002) and SCI (0.60, P = 0.02). Conclusions: HD leads to a reduction of CI due to ultrafiltration. Haemodynamic monitoring identifies a significant number of HD patients with cardiac impairment that are at risk for increased mortality.
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