Evidence map›Paper›PMID 31407042›Full record

ReviewIntensive care medicine2019

Mechanisms for hemodynamic instability related to renal replacement therapy: a narrative review.

Adrianna Douvris, Khalid Zeid, Swapnil Hiremath, Sean M Bagshaw, Ron Wald, William Beaubien-Souligny, Jennifer Kong, Claudio Ronco, Edward G Clark

Registry-linked trialAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Intensive care medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07643597 (Volume Removal Intolerance During Net Ultrafiltration in Acute Kidney Injury Patients), which is not on this map. Cited by 87 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
87citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT07643597 recruitingnot on this mapstarted 2026, after this paper: background citation

Volume Removal Intolerance During Net Ultrafiltration in Acute Kidney Injury Patients

TypeobservationalSponsorHospital Las HiguerasRan2026 to 2027Enrolled128ConditionsAcute Kidney Injury, Fluid Overload, Fluid Overload in Dialysis Patients, Critical Illness
3 · Its place in the literature

Who cites it

87 citing papers in PubMed, 7 syntheses or guidelines pooled it.

  1. Optimal management of cardiac surgery patients using direct oral anticoagulants: recommendations for clinical practice.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2023
    Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Regional Citrate Anticoagulation or Heparin Anticoagulation for Renal Replacement Therapy in Patients With Liver Failure: A Systematic Review and Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Pooled it
  7. Guideline
  8. Trial
  9. Trial
  10. Trial
  11. Trial
  12. Trial
  13. Review
  14. Article
  15. Prognosis of Long-Term Continuous Renal Replacement Therapy and the Impact of Combined Continuous Intravenous Sodium Infusion Therapy.Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy · 2026
    Article
  16. 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 · 2026
    Review
  17. Observational
  18. Article
  19. Review
  20. Article

27 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Adrianna DouvrisThe Ottawa Hospital, Department of Medicine and Kidney Research Centre, Ottawa Hospital Research Institute, University of Ottawa, 1967 Riverside Drive, Ottawa, ON, K1H 7W9, Canada.
Khalid ZeidFaculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Swapnil HiremathThe Ottawa Hospital, Department of Medicine and Kidney Research Centre, Ottawa Hospital Research Institute, University of Ottawa, 1967 Riverside Drive, Ottawa, ON, K1H 7W9, Canada.
Sean M BagshawFaculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
Ron WaldSt. Michael's Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
William Beaubien-SoulignySt. Michael's Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
Jennifer KongThe Ottawa Hospital, Department of Medicine and Kidney Research Centre, Ottawa Hospital Research Institute, University of Ottawa, 1967 Riverside Drive, Ottawa, ON, K1H 7W9, Canada.
Claudio RoncoDepartment of Medicine, Università degli Studi di Padova and International Renal Research Institute, St. Bortolo Hospital, Vicenza, Italy.
Edward G ClarkThe Ottawa Hospital, Department of Medicine and Kidney Research Centre, Ottawa Hospital Research Institute, University of Ottawa, 1967 Riverside Drive, Ottawa, ON, K1H 7W9, Canada. edclark@toh.ca.ORCID 0000-0002-6767-1197

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Hemodynamic instability related to renal replacement therapy (HIRRT) is a frequent complication of all renal replacement therapy (RRT) modalities commonly used in the intensive care unit. HIRRT is associated with increased mortality and may impair kidney recovery. Our current understanding of the physiologic basis for HIRRT comes primarily from studies of end-stage kidney disease patients on maintenance hemodialysis in whom HIRRT is referred to as 'intradialytic hypotension'. Nonetheless, there are many studies that provide additional insights into the underlying mechanisms for HIRRT specifically in critically ill patients. In particular, recent evidence challenges the notion that HIRRT is almost entirely related to excessive ultrafiltration. Although excessive ultrafiltration is a key mechanism, multiple other RRT-related mechanisms may precipitate HIRRT and this could have implications for how HIRRT should be managed (e.g., the appropriate response might not always be to reduce ultrafiltration, particularly in the context of significant fluid overload). This review briefly summarizes the incidence and adverse effects of HIRRT and reviews what is currently known regarding the mechanisms underpinning it. This includes consideration of the evidence that exists for various RRT-related interventions to prevent or limit HIRRT. An enhanced understanding of the mechanisms that underlie HIRRT, beyond just excessive ultrafiltration, may lead to more effective RRT-related interventions to mitigate its occurrence and consequences.

Indexed as

Acute Kidney InjuryFluid ShiftsHemodynamicsHumansKidneyKidney Failure, ChronicOsmolar ConcentrationRenal Replacement TherapyAcute kidney injuryBlood pressureDialysisHemodynamic instabilityHypotensionIntradialytic hypotensionRenal replacement therapy

Identifiers

PMID31407042
PMCPMC6773820

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

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.