%0 Journal Article
%T Effect of On-Line Hemodiafiltration on Dry Weight Adjustment in Intradialytic  Hypotension-Prone Patients: Comparative Study of Conventional Hemodialysis and On-Line Hemodiafiltration
%A Sun Woo Kang
%J Open Journal of Nephrology
%P 1-7
%@ 2164-2869
%D 2014
%I Scientific Research Publishing
%R 10.4236/ojneph.2014.41001
%X <p style=\"text-align:justify;\">
	<span style=\"font-size:10.0pt;line-height:99%;font-family:;\" \"=\"\"><span style=\"font-family:Verdana;line-height:1.5;\">Introduction: Correct adjustment of dry weight after
hemodialysis (HD) with no signs of hypervolemia is important. Intradialytic
hypotension (IDH) is the most common complication during HD. IDH occurs in 15%
to 30% and possibly in up to 50% of dialysis sessions. IDH augments mortality
essentially due to chronic overhydration and the inability to reach the proper
dry weight. On-line hemodiafiltration (ol-HDF) has been reported to reduce the
frequency of IDH. The aim of this study was to assess the effect of ol-HDF on
hemodynamic stability and dry weight adjustment compared with low-flux HD.
Methods: IDH-prone HD patients at our center were enrolled. This study was
designed as a crossover trial with two phases (A arm: low-flux HD for 8 weeks
followed by ol-HDF for 8 weeks </span><i><span style=\"font-family:Verdana;line-height:1.5;\">vs.</span></i><span style=\"font-family:Verdana;line-height:1.5;\"> B
arm: ol-HDF for 8 weeks followed by low-flux HD for 8 weeks) and two treatment
arms (ol-HDF</span><i><span style=\"font-family:Verdana;line-height:1.5;\"> vs.</span></i><span style=\"font-family:Verdana;line-height:1.5;\"> low-flux HD), each
phase lasting 8 weeks. We measured the proportion of body water using a body
composition monitor (BCM). Results: In a comparison of the systolic blood
pressure (SBP) and diastolic blood pressure (DBP) reductions from the baseline
blood pressure between the HD and ol-HDF groups, statistically significant
differences were observed only in the SBP of the B arm (SBP: HD </span><i><span style=\"font-family:Verdana;line-height:1.5;\">vs.</span></i><span style=\"font-family:Verdana;line-height:1.5;\"> HDF, -9.83 ¡À 6.64 </span><i><span style=\"font-family:Verdana;line-height:1.5;\">vs.</span></i><span style=\"font-family:Verdana;line-height:1.5;\"> -4.62 ¡À 1.61 mmHg, p = 0.036; DBP:
HD </span><i><span style=\"font-family:Verdana;line-height:1.5;\">vs.</span></i><span style=\"font-family:Verdana;line-height:1.5;\"> HDF, -3.29 ¡À 4.05 </span><i><span style=\"font-family:Verdana;line-height:1.5;\">vs. </span></i><span style=\"font-family:Verdana;line-height:1.5;\">-1.86 ¡À 1.49 mmHg, p = 0.261).
Neither the mean of the interdialytic body weight gains nor the frequency of
IDH was different between the A and B arms (p = 0.817 and p = 0.562,
respectively). In terms of dialysis modality, there were no significant
differences in the amount of overhydration between the conventional
%K On-Line Hemodiafiltration
%K Hemodialysis
%K Intradialytic Hypotension
%K Body Composition Monitor
%K Dry Body Weight
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=43547