• Renal failure · Jan 2012

    Randomized Controlled Trial

    Prevention of intradialytic hypotension in patients with acute kidney injury submitted to sustained low-efficiency dialysis.

    • Emerson Q Lima, Ricardo G Silva, Endrigo L S Donadi, Alex B Fernandes, Jeferson R Zanon, Klinger R D Pinto, and Emmanuel A Burdmann.
    • Division of Nephrology, Hospital de Base, Sao Jose do Rio Preto Medical School, Sao Jose do Rio Preto, Brazil. equintino@uol.com.br
    • Ren Fail. 2012 Jan 1;34(10):1238-43.

    ObjectivesThis study evaluated the effects of a protocol aiming to reduce hypotension in acute kidney injury (AKI) patients submitted to sustained low-efficiency dialysis (SLED).MethodsPatients were randomly assigned to two SLED prescriptions-control group, dialysate temperature was 37.0°C with a fixed sodium concentration [138 mEq/L] and ultrafiltration (UF) rate; and profiling group, dialysate temperature was 35.5°C with a variable sodium concentration [150-138 mEq/L] and UF rate.ResultsSixty-two SLED sessions were evaluated (34 in profiling and 28 in control). Patients (n = 31) were similar in terms of gender, age, and Sequential Organ Failure Assessment (SOFA) score. Dialysis time, dialysis dose, and post-dialysis serum sodium were similar in both groups. The profiling group had significantly less hypotension episodes (23% vs. 57% in control, p = 0.009) and achieved higher UF volume (2.23 ± 1.25 L vs. 1.59 ± 1.03 L in control, p = 0.04) when compared with control group.ConclusionsSLED protocol with modulation of dialysate temperature, sodium, and UF profiling showed similar efficacy but less intradialytic hypotension when compared with a standard SLED prescription.

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