Hemodynamics in Chronic Hemodialysis Patients Undergoing Isolated Ultrafiltration Compared to Conventional Hemodialysis

Patients treated with hemodialysis (HD) bear increased risk of cardiovascular events, which results in high morbidity and mortality among this cohort of patients. Intradialytic hypotension (IDH), which is an independent risk factor for mortality, occurs in up to 20% of hemodialysis session and may lead to myocardial stunning and cerebral ischemia resulting in increased white matter lesions, gastrointestinal ischemia and shunt vessel thrombosis. Due to the deleterious effects of IDH during HD, preventive measurements such as limiting interdialytic weight gain are recommended, but frequently fluid and salt restriction are not adhered to, thus increasing dialysis time or frequency of treatments is a common strategy in those patients.

Inclusion Criteria:Written consent of the participant after being informedAt least 18 years of ageEnd stage kidney disease patient undergoing hemodialysisDry weight stable for a minimum of one monthInterdialytic weight gain of >2 liters in the short interdialytic intervalExclusion Criteria:No informed consent was obtainedPatients with a pacemaker or implanted medical device that prevents compliance with study regulationsPatients treated with hemodiafiltrationPatients treated with medium cut-off membranes (Theranova, Baxter)Patients with recurrent severe hyperkalemia after the short interdialytic interval (K+ concentration > 6.0 mmol/L, requiring more than 2 hours of dialysis to ameliorate the post-dialytic shift from other compartments.Women of childbearing age not using contraception