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)