Details

Autor(en) / Beteiligte

• Chou, Jason A.
• Kalantar-Zadeh, Kamyar

Titel

Volume Balance and Intradialytic Ultrafiltration Rate in the Hemodialysis Patient

Ist Teil von

• Current heart failure reports, 2017-10, Vol.14 (5), p.421-427

Ort / Verlag

New York: Springer US

Erscheinungsjahr

2017

Quelle

SpringerLink

Beschreibungen/Notizen

• Purpose of Review Volume management in hemodialysis patients is often challenging. Assessing volume status and deciding how much fluid to remove during hemodialysis, the so-called ultrafiltration rate (UFR), has remained a conundrum. Recent Findings To date there is no objective assessment tool to determine the needed UFR during each hemodialysis session. Higher volume overload or higher UFR is associated with poor outcomes including worse mortality and unfavorable clinical outcomes. We suggest combined use of the following criteria to determine UFR or post-dialysis target dry weight: pre-hemodialysis blood pressure and its intradialytic changes, muscle cramps, dyspnea from pulmonary vascular congestion, peripheral edema, tachycardia or palpitation, headache or lightheadedness, perspiration, and post-dialysis fatigue. Restricting fluid and salt intake—and high-dose loop diuretic use in cases of residual kidney function—can be helpful in controlling fluid gains. More frequent and more severe hypotensive episodes are associated with poor outcomes including higher death risk.