NDT Advance Access originally published online on August 16, 2005
Nephrology Dialysis Transplantation 2005 20(10):2043-2049; doi:10.1093/ndt/gfi056
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© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Editorial Review
Measurement of relative blood volume changes during haemodialysis: merits and limitations
Dialysis Center Groningen, University Medical Center Groningen and University of Groningen, Department of Internal Medicine, Division of Nephrology, Groningen, The Netherlands
Correspondence and offprint requests to: J. J. Dasselaar, Dialysis Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands. Email: j.j.dasselaar@dcg.umcg.nl
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Introduction |
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Dialysis hypotension is estimated to occur in
20% of haemodialysis (HD) sessions [1] and can lead to serious vascular complications such as cerebral infarction and cardiac and mesenteric ischaemia [2,3]. It may contribute to chronic overhydration due to an inability to reach dry weight and may lead to under-dialysis [1,2,4]. Prevention of dialysis hypotension, therefore, is an important challenge to the dialysis staff. The initiating factor in the pathogenesis of dialysis hypotension is a decrease in blood volume which results from the imbalance between the ultrafiltration rate and the plasma refilling rate [5]. Devices that continuously and non-invasively monitor relative blood volume (RBV) changes during HD are being advocated as a tool to maintain an adequate volume of the intravascular compartment in order to avoid dialysis hypotension [6–8]. Nowadays, most manufacturers have incorporated an |
Cardiovascular compensatory mechanisms |
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Non-invasive measurement of changes in blood volume |
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Relationship between RBV changes and blood pressure |
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Modification of the dialysis prescription on the basis of RBV changes |
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Problems related to the measurement of RBV changes |
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Influence of hydration status
Intravascular blood volume distribution
Postural changes
Miscellaneous factors that may influence RBV measurements
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Conclusions and recommendations |
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