ArticleJournal of the American Society of Nephrology : JASN2019
Renal Perfusion during Hemodialysis: Intradialytic Blood Flow Decline and Effects of Dialysate Cooling.
Article in Journal of the American Society of Nephrology : JASN, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it, 72 citations in OpenAlex.
- Meta-Analysis of Prophylactic Renal Replacement Therapy after Cardiac Catheterization in Patients with Chronic Kidney Disease.Anatolian journal of cardiology · 2023Pooled it
- Blood pressure and volume management in dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference.Kidney international · 2020Guideline
- BioImpedance Spectroscopy to maintain Renal Output: the BISTRO randomised controlled trial.Health technology assessment (Winchester, England) · 2025Trial
- Randomized trial comparing standard versus thermocontrolled haemodialysis using intradialytic cardiac, brain and renal magnetic resonance imaging.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2024Trial
- Effect of ultrafiltration profiling on outcomes among maintenance hemodialysis patients: a pilot randomized crossover trial.Journal of nephrology · 2021Trial
- Texture Analysis of Multiparametric Kidney MRI-A Non-Invasive Approach to Chronic Kidney Disease State.Biomedicines · 2026Article
- Characterization of residual kidney function in chronic hemodialysis patients using plasma metabolomics.Scientific reports · 2026Article
- Evaluating and Guiding Outpatient Recovery from Acute Kidney Injury Requiring Dialysis.Kidney360 · 2026Article
- Intradialytic cerebral blood flow reduction occurs irrespective of vascular access type: a comparative study.BMC nephrology · 2026Article
- Dialyzer characteristics are associated with differential effects on intradialytic microvascular tissue perfusion.Annals of medicine and surgery (2012) · 2026Article
- Implementing a Protocol for Incremental Hemodialysis in Incident Patients With Kidney Failure: A Quality Improvement Initiative.Canadian journal of kidney health and disease · 2026Article
- Coronary Artery Disease and Intradialytic Myocardial Ischemia in Hemodialysis: An Exploratory Study Using Intradialytic Imaging.Kidney medicine · 2025Article
- Dialysis and cognitive impairment.Nature reviews. Nephrology · 2025Review
- Dialysis Dependence in Standard versus Accelerated Initiation of KRT in AKI: A Post Hoc Analysis.Clinical journal of the American Society of Nephrology : CJASN · 2025Article
- Impact of early initiation of renal replacement therapy in patients on venoarterial ECMO using target trial emulation with Japanese nationwide data.Scientific reports · 2025Article
- Hemodialysis-induced renal perfusion decline: unraveling the pathophysiological mechanisms linking intradialytic circulatory stress to residual renal function loss.Frontiers in pharmacology · 2025Article
- Randomized Trial Demonstrating No Translocation of Intact Intestinal Bacteria During Hemodialysis or Hemodiafiltration.Kidney international reports · 2025Article
- Intradialytic cardiovascular injury is lowest in high-volume haemodiafiltration: a randomized cross-over trial in four intermittent dialysis strategies.Clinical kidney journal · 2024Article
- Non-invasive intradialytic percutaneous perfusion monitoring: a view to the heart through the skin.Frontiers in nephrology · 2023Article
- Fluid Overload and Precision Net Ultrafiltration in Critically Ill Patients.Cardiorenal medicine · 2023Review
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundResidual renal function (RRF) confers survival in patients with ESRD but declines after initiating hemodialysis. Previous research shows that dialysate cooling reduces hemodialysis-induced circulatory stress and protects the brain and heart from ischemic injury. Whether hemodialysis-induced circulatory stress affects renal perfusion, and if it can be ameliorated with dialysate cooling to potentially reduce RRF loss, is unknown.
methodsWe used renal computed tomography perfusion imaging to scan 29 patients undergoing continuous dialysis under standard (36.5°C dialysate temperature) conditions; we also scanned another 15 patients under both standard and cooled (35.0°C) conditions. Imaging was performed immediately before, 3 hours into, and 15 minutes after hemodialysis sessions. We used perfusion maps to quantify renal perfusion. To provide a reference to another organ vulnerable to hemodialysis-induced ischemic injury, we also used echocardiography to assess intradialytic myocardial stunning.
resultsDuring standard hemodialysis, renal perfusion decreased 18.4% (
conclusionsThis study shows an acute decrease in renal perfusion during hemodialysis, a first step toward pathophysiologic characterization of hemodialysis-mediated RRF decline. Dialysate cooling ameliorated this decline but this effect did not reach statistical significance. Further study is needed to explore the potential of dialysate cooling as a therapeutic approach to slow RRF decline.
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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.