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Kidney Week

Abstract: TH-PO217

Effect of Sodium and Ultrafiltration Modeling vs. Low-Temperature Dialysate on Prevention of Intradialytic Hypotension: Single-Center Study from India

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Bhalla, Anil, Sir Ganga Ram Hospital , New Delhi, India
  • Anand, Yogeshman, Sir Ganga Ram Hospital, New Delhi, India
  • Rana, Devinder S., Sir Ganga Ram Hospital, New Delhi, India
  • Gupta, Ashwani, Sir Ganga Ram Hospital , New Delhi, India
  • Malik, Manish, Sir Ganga Ram Hospital and GRIPMER, New Delhi, India
  • Gupta, Anurag, Synegy Hospital, Uttarakhand, India
  • Bhargava, Vinant, Sir Ganga Ram Hospital , New Delhi, India
  • Tiwari, Vaibhav, Sir Ganga Ram Hospital, New Delhi, India
Background

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.

Methods

A total of 320 patients with chronic kidney disease (CKD) stage V on conventional hemodialysis (HD) for at least twice weekly for a minimum of 3 months were observed for the occurrence of ≥1 intradialytic hypotensive episodes per month. After full filling the inclusion and exclusion criteria, 60 patients were randomized 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).
Both groups underwent 240 sessions of hemodialysis.

Results

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.