P1267EFFECT OF SODIUM AND ULTRAFILTRATION MODELING VERSUS LOW TEMPERATURE DIALYSATE IN PREVENTION OF INTRADIALYSIS HYPOTENSION: A SINGLE CENTRE STUDY FROM INDIA. (6th June 2020)

• Record Type: Journal Article
• Authors: Tiwari, Vaibhav; Gupta, Anurag; Anand, Yogeshman; Bhargava, Vinant; Malik, Manish; Gupta, Ashwani; Bhalla, A K; Rana, Devinder Singh
• Is Part Of: Nephrology dialysis transplantation. Volume 35(2020)Supplement 3
• Publication Date: 2020-06-06
• Subjects: Nephrology -- Periodicals; Hemodialysis -- Periodicals; Kidneys -- Transplantation -- Periodicals; Hemodialysis; Kidneys -- Transplantation; Nephrology; Periodicals; 616.61
• DOI: 10.1093/ndt/gfaa142.P1267
• Languages: English
• ISSNs: 0931-0509

Abstract

Abstract: Background and Aims: Symptomatic intradialytic hypotension is the most frequent complication in patients receiving hemodialysis. It complicates 5 to 30 percent of all dialysis treatments. In our study, we aimed to compare the effect of sodium and ultrafiltration modeling versus low-temperature dialysate on the occurrence of intradialytic hypotensive episodes. Method: Single center, prospective, randomized trial. Patients with chronic kidney disease (CKD) stage V on maintenance hemodialysis (HD) for at least twice weekly for a minimum of 3 months were observed for the occurrence of ≥1 intradialytic hypotensive episode per month. After full filling the inclusion and exclusion criteria, patients were randomized 1:1 ratio into two groups based on computer-generated randomization numbers allotted to them by the dialysis coordinator. Group 1: Underwent dialysis with sodium and Ultrafiltration modeling (Linearly decreasing dialysate sodium from 141 mmol/L to 128 mmol/L and linearly decreasing ultrafiltration rate). Group 2: Underwent dialysis with low-temperature dialysate (36 degrees Celsius). Primary outcome was number of hypotensive episodes per month. Secondary outcomes were interdialytic weight gain and ultrafiltration volume per session. Results: A total of 320 patients were observed for 3 months in our centre. Intradialytic hypotension was found in 18.75 % of patients. Diabetic nephropathy (61.66%) was the leading cause of end-stage renal disease in these patients. There was no significant difference between the two groups in mean arterial blood pressure, hemoglobin, cardiac status, and serum albumin before dialysis. Both groups had a similar incidence of intradialytic hypotensive episodes (P >0.05). Interdialytic weight gain and ultrafiltration volume removed per session were also similar in both groups. Conclusion: Sodium and ultrafiltration modeling and low-temperature dialysate were both equally effective in the prevention of intradialytic hypotensive episodes.