BACKGROUND: Volume overload contributes to the pathogenesis of hypertension in hemodialysis (HD) patients. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: The Hemocontrol (HC) system (Gambro), which automatically adjusts ultrafiltration rate and dialysate conductivity during dialysis, has been suggested to improve hemodynamic tolerance and thereby facilitate fluid removal. A 6-mo randomized, controlled trial was performed to test the hypothesis that the addition of the HC system to a systematic BP management protocol may lower home BP in comparison with standard HD as primary end point. Secondary end points were the number of nursing interventions during dialysis and health-related quality of life. RESULTS: Complete BP data were available for 36 of the 44 patients who completed the trial. There was a statistically significant overall decrease in systolic BP during the study period (P = 0.005). However, the difference between the HC group and the standard HD group was NS (HC: from 147.8 +/- 21.7 to 139.8 +/- 16.2 mmHg; standard HD: from 141.9 +/- 19.2 to 135.2 +/- 9.9 mmHg). The number of HD sessions that required nursing interventions decreased in the HC group, whereas it increased in the standard HD group (HC: 42.9% reduction; standard HD: 35.7% increase; P = 0.04). There was also a significant improvement in health-related quality of life in the HC group but not in the standard HD group. CONCLUSIONS: These results suggest that the addition of the HC system to a systematic BP management protocol provides no additional benefit with regard to BP reduction. However, the HC system may improve the patient tolerability to dialysis.
RCT Entities:
BACKGROUND: Volume overload contributes to the pathogenesis of hypertension in hemodialysis (HD) patients. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: The Hemocontrol (HC) system (Gambro), which automatically adjusts ultrafiltration rate and dialysate conductivity during dialysis, has been suggested to improve hemodynamic tolerance and thereby facilitate fluid removal. A 6-mo randomized, controlled trial was performed to test the hypothesis that the addition of the HC system to a systematic BP management protocol may lower home BP in comparison with standard HD as primary end point. Secondary end points were the number of nursing interventions during dialysis and health-related quality of life. RESULTS: Complete BP data were available for 36 of the 44 patients who completed the trial. There was a statistically significant overall decrease in systolic BP during the study period (P = 0.005). However, the difference between the HC group and the standard HD group was NS (HC: from 147.8 +/- 21.7 to 139.8 +/- 16.2 mmHg; standard HD: from 141.9 +/- 19.2 to 135.2 +/- 9.9 mmHg). The number of HD sessions that required nursing interventions decreased in the HC group, whereas it increased in the standard HD group (HC: 42.9% reduction; standard HD: 35.7% increase; P = 0.04). There was also a significant improvement in health-related quality of life in the HC group but not in the standard HD group. CONCLUSIONS: These results suggest that the addition of the HC system to a systematic BP management protocol provides no additional benefit with regard to BP reduction. However, the HC system may improve the patient tolerability to dialysis.
Authors: Rajiv Agarwal; Sangeetha Satyan; Pooneh Alborzi; Robert P Light; Getachew G Tegegne; Helmneh S Mazengia; Paulos M Yigazu Journal: Am J Nephrol Date: 2009-02-27 Impact factor: 3.754
Authors: Kelvin C W Leung; Robert R Quinn; Pietro Ravani; Henry Duff; Jennifer M MacRae Journal: Clin J Am Soc Nephrol Date: 2017-10-10 Impact factor: 8.237
Authors: Hyo-Wook Gil; Kitae Bang; So Young Lee; Byoung Geun Han; Jin Kuk Kim; Young Ok Kim; Ho Cheol Song; Young Joo Kwon; Yong-Soo Kim Journal: J Korean Med Sci Date: 2014-05-30 Impact factor: 2.153