HDCN Abstract:  ASN Annual Meeting -- San Francisco  

Schmidt R, Roeher O, Korth S, et al.

Intradialytic Hypotension (IDH): Effective Reduction of Hypotensive Episodes (HE) by Blood Pressure-Guided Automated Ultrafiltration Control (bioLogic RR Comfort).

ASN Annual Meeting -- San Francisco
J Am Soc Nephrol (Nov) 18:707A 2007

Hypotensive episodes (HEs) still account for the majority of dialysis-related adverse events. Various approaches using surrogate indicators of blood pressure behaviour were developed to avoid HEs. We tested an automated biofeedback-controlled system, bioLogic RR Comfort (biolRR), which is able to adapt ultrafiltration rate directly in response to oscillometric blood pressure recordings.

The aim of the study was to determine the effect of biolRR on the frequency and severity of intradialytic hypotensive episodes in hypotension-prone patients.

Methods: 27 patients with a defined predisposition to IDH were included into an observational study, documenting almost 2000 treatments over a period of 25 weeks.

Results: In presence of biolRR, the frequency of dialysis treatments with HEs was decreased by 43% (without biolRR: 58%; with biolRR: 33%). In contrast to 42% of treatments without HEs in the absence of biolRR, 67% of treatments remained free of HEs with biolRR in use. biolRR was effective both in severe (difference >=25mmHg: -46%) and mild HEs (difference <25mmHg: -55%). Similarly, clinical symptoms related to HEs as well as the need for therapeutic actions were markedly reduced. It is of note, that in 55% of treatments systolic blood pressure increased in the last hour in patients treated with biolRR. Compared to an automated blood pressure system without guideline technique the frequency of blood pressure recordings was decreased by 54%.

Conclusion: The results clearly demonstrate that the blood pressure stabilization system bioLogic RR Comfort effectively and significantly reduces the frequency and severity of HEs as well as the occurrence of HE-related clinical symptoms. These beneficial effects may stabilize the clinical course of patients with a predisposition to IDH.



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