Effects of Ultrafiltration on Blood Flow in Kidney Disease Patients
Author Information
Author(s): Klijn E, Van Genderen M, Betjes M, Bakker J, Van Bommel J
Primary Institution: Erasmus MC University Medical Center
Hypothesis
Large decreases in volume status due to ultrafiltration with intermittent hemodialysis in patients with end-stage kidney disease would decrease systemic hemodynamics but would not affect parameters of microcirculatory perfusion.
Conclusion
Ultrafiltration leads to a significant decrease in volume status in patients with end-stage kidney disease, but this does not result in large decreases in peripheral and microcirculatory perfusion.
Supporting Evidence
- Stroke volume decreased from 75 ml to 51 ml during ultrafiltration.
- Mean arterial pressure decreased from 102 mmHg to 85 mmHg during ultrafiltration.
- Sublingual microvascular flow index slightly decreased from 3.0 to 2.8.
- Vessel density measured with SDF decreased from 10.6 n/mm to 9.9 n/mm.
Takeaway
When doctors take out fluid from patients with kidney disease, it lowers their blood volume but doesn't always mean their blood flow to small vessels is worse.
Methodology
Patients on chronic intermittent hemodialysis were monitored for changes in stroke volume, heart rate, blood pressure, and microcirculatory perfusion before and after ultrafiltration.
Participant Demographics
21 patients (13 males, median age 59 years)
Statistical Information
P-Value
P < 0.001
Confidence Interval
IQR provided for various measurements
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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