Luik AJ, Spek J, van Kujik W, de Heer F, van Hooff JP, Leunissen KML
The effect of fluid loading on blood pressure in hemodialysis patients
Am Soc Nephrol
J Am Soc Nephrol (abstract) (Nov) 6:607 1995

The degree of volume dependence of blood pressure on volume status in dialysis patients is somewhat controversial. In this nice study 10 patients were deliberately subjected to a normovolemic and a hypervolemic fluid removal/repletion strategy during a given dialysis/interdialytic interval. In the normovolemic period, target post-dialysis weight was 1 kg below dry weight, and patients were instructed to gain only 0-1 kg. In the hypervolemic period, post-dialysis weight was 1 kg above dry weight, and patients were instructed to gain 2 kg. The blood pressure was greater in the hypervolemic period in only 3/10 patients. However, cardiac index and vena caval diameter was significantly higher during the hypervolemic periods. Forearm vascular resistance was lower during the hypervolemic period, compensating for the increase in cardiac index in many of these patients.

Comment: Although BP increased in only 3/10 patients after volume loading, it is apparent that volume loading has deleterious effects, manifested by increased cardiac index and vena caval diameter. (Daugirdas)

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Am Soc Nephrol
CRF by organ system : Cardiovascular/Hypertension
Basic hemodialysis : Complications (acute)