Isonatric Dialysis Biofeedback in Hemodiafiltration with Online Regeneration of Ultrafiltrate in Hypertensive Hemodialysis Patients: A Randomized Controlled Study

• Published in: Blood purification Vol. 41; no. 1-3; pp. 87 - 93
• Main Authors: Chevalier, Louise, Tielemans, Christian, Debelle, Frederic, Vandervelde, Dominique, Fumeron, Christine, Mandart, Lise, Stolear, Jean-Claude, Simon, Isabelle, Delmas, Yahsou, Testa, Angelo, Mat, Olivier, Tezenas du Montcel, Sophie, Mercadal, Lucile
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland 01.01.2016
• Subjects: Aged; Aged, 80 and over; Antihypertensive Agents - therapeutic use; Blood Pressure - drug effects; Female; Fluid Therapy; Hemodiafiltration; Hemodialysis Solutions - therapeutic use; Humans; Hypertension - blood; Hypertension - complications; Hypertension - pathology; Hypertension - therapy; Hypotension - diagnosis; Hypotension - physiopathology; Kidney Diseases - blood; Kidney Diseases - complications; Kidney Diseases - pathology; Kidney Diseases - therapy; Male; Middle Aged; Monitoring, Physiologic; Original Paper; Sodium - therapeutic use; Hypertension; Biofeedback; Dialysis; Sodium; Hemodialysis
• ISSN: 0253-5068; 1421-9735
• DOI: 10.1159/000441967

Dialysis biofeedback in hemodiafiltration with online regeneration of ultrafiltrate (HFR) could help to improve arterial hypertension. We evaluated the impact of isonatric HFR (HFR-iso) on hypertension control compared to conventional HFR. Forty-seven hemodialysis patients were included and randomized (ratio 2/1) HFR-iso versus HFR during 24 dialysis sessions. In the HFR-iso group (32 patients, 768 dialysis sessions), the predialytic systolic blood pressure (BP) decreased from S1 to S24 of 9 ± 20 mm Hg and increased of 5 ± 24 mm Hg in the HFR group (15 patients, 360 dialysis sessions), variation that differed between the 2 groups (ΔS1-S24, p = 0.035; interaction group*time, p = 0.012). The diastolic BP (HFR-iso -3 ± 14 mm Hg vs. HFR 5 ± 13 mm Hg; p = 0.088), the DDD of antihypertensive treatment and the dry weight did not vary significantly during the study. Number of sessions complicated by symptomatic hypotension was similar in the 2 groups. HFR-iso improved BP control without increasing dialysis hypotension episodes. Short Summary: In this multicenter, open-label, controlled, randomized study, we evaluated the impact of dialysis biofeedback in HFR on arterial hypertension compared to conventional HFR. We observed that HFR-iso improved arterial BP control without increasing dialysis hypotension episodes.