Maurizio Bossola1, Enrico Di Stasio2, Tania Monteburini3, Emanuele Parodi4, Fabio Ippoliti5, Stefano Cenerelli5, Stefano Santarelli3, Pier Eugenio Nebiolo4, Vittorio Sirolli6, Mario Bonomini6, Manuela Antocicco7, Giuseppe Zuccalà7, Alice Laudisio8. 1. Hemodialysis Service, Catholic University, Rome, Italymaurizio.bossola@gmail.com. 2. Department of Clinical Chemistry, Catholic University, Rome, Italy. 3. Department of Nephrology, Hospital "Carlo Urbani", Jesi, Italy. 4. Department of Nephrology, Hospital "Umberto Parini", Aosta, Italy. 5. Department of Nephrology, Hospital "Civile", Senigallia, Italy. 6. Department of Nephrology, University of Chieti, Chieti, Italy. 7. Department of Gerontology, Geriatrics and Psychiatry, Catholic University of the Sacred Hearth, Rome, Italy. 8. Unit of Geriatrics, Department of Medicine, Campus Bio-Medico di Roma University, Rome, Italy.
Abstract
INTRODUCTION: The present study aimed to determine the variables that are associated with a longer dialysis recovery time (DRT) and to define the relationship that exists between DRT and the ultrafiltration rate (UFR) in prevalent chronic hemodialysis (CHD) patients. METHODS: We studied 210 prevalent CHD of 5 hemodialysis units in Central Italy. Patients were invited to answer to the question: "How long does it take you to recover from a dialysis session?" Answers to this question were subsequently converted into minutes. Demographic, clinical and laboratory parameters were recorded for each patient as well as the UFR (mL/kg/h), the dialysate sodium concentration and temperature. RESULTS: Median DRT was 180 min (60-420). Ninety five (45%) patients had a DRT ≥ the median value. Mean UFR was 9.2 ± 3.0 mL/kg/h. Patients with a lower DRT had a less prevalent disability in the instrumental activities daily living, had a higher UFR, and a lower dialysate temperature, as compared with subjects with higher DRT. According to the logistic regression model, UFR was associated with a DRT below the median (i.e., 180) in the unadjusted model (OR 1.12; 95% CI 1.02-1.23; p = 0.019), after adjusting for age and sex (OR 1.11; 95% CI 1.01-1.22; p = 0.025), and in the fully adjusted model (OR 1.11; 95% CI 1.04-1.22; p = 0.040). UFR increase was associated with increasing probability of DRT below the median (p for trend = 0.035). The highest tertile of DRT was associated with UFR below the mean value (i.e., 9.2 mL/kg/h) in multinomial logistic regression having the lowest DRT tertile as reference. DRT was significantly lower in patients with UFR > 13 mL/kg/h than in patients with UFR 10-13 or < 10 mL/kg/h. CONCLUSION: DRT is inversely associated with UFR in CHD patients. Whether a high UFR should be recommended to reduce the DRT needs to be elucidated through an adequate prospective randomized study.
INTRODUCTION: The present study aimed to determine the variables that are associated with a longer dialysis recovery time (DRT) and to define the relationship that exists between DRT and the ultrafiltration rate (UFR) in prevalent chronic hemodialysis (CHD) patients. METHODS: We studied 210 prevalent CHD of 5 hemodialysis units in Central Italy. Patients were invited to answer to the question: "How long does it take you to recover from a dialysis session?" Answers to this question were subsequently converted into minutes. Demographic, clinical and laboratory parameters were recorded for each patient as well as the UFR (mL/kg/h), the dialysate sodium concentration and temperature. RESULTS: Median DRT was 180 min (60-420). Ninety five (45%) patients had a DRT ≥ the median value. Mean UFR was 9.2 ± 3.0 mL/kg/h. Patients with a lower DRT had a less prevalent disability in the instrumental activities daily living, had a higher UFR, and a lower dialysate temperature, as compared with subjects with higher DRT. According to the logistic regression model, UFR was associated with a DRT below the median (i.e., 180) in the unadjusted model (OR 1.12; 95% CI 1.02-1.23; p = 0.019), after adjusting for age and sex (OR 1.11; 95% CI 1.01-1.22; p = 0.025), and in the fully adjusted model (OR 1.11; 95% CI 1.04-1.22; p = 0.040). UFR increase was associated with increasing probability of DRT below the median (p for trend = 0.035). The highest tertile of DRT was associated with UFR below the mean value (i.e., 9.2 mL/kg/h) in multinomial logistic regression having the lowest DRT tertile as reference. DRT was significantly lower in patients with UFR > 13 mL/kg/h than in patients with UFR 10-13 or < 10 mL/kg/h. CONCLUSION: DRT is inversely associated with UFR in CHD patients. Whether a high UFR should be recommended to reduce the DRT needs to be elucidated through an adequate prospective randomized study.
Authors: Murilo Guedes; Roberto Pecoits-Filho; Juliana El Ghoz Leme; Yue Jiao; Jochen G Raimann; Yuedong Wang; Peter Kotanko; Thyago Proença de Moraes; Ravi Thadhani; Franklin W Maddux; Len A Usvyat; John W Larkin Journal: BMC Nephrol Date: 2020-12-07 Impact factor: 2.388
Authors: Eran Y Bellin; Alice M Hellebrand; Steven M Kaplan; Jordan G Ledvina; William T Markis; Nathan W Levin; Allen M Kaufman Journal: Hemodial Int Date: 2022-04-06 Impact factor: 1.543