Improvement of intradialytic hypotension in diabetic hemodialysis patients using vitamin E-bonded polysulfone membrane dialyzers
- PMID: 22845774
- PMCID: PMC3500504
- DOI: 10.1111/j.1525-1594.2012.01483.x
Improvement of intradialytic hypotension in diabetic hemodialysis patients using vitamin E-bonded polysulfone membrane dialyzers
Abstract
Currently, there are no detailed reports on the effects of vitamin E-bonded polysulfone (PS) membrane dialyzers on intradialytic hypotension (IDH) in diabetic hemodialysis (HD) patients. This study was designed to evaluate changes in intradialytic systolic blood pressure (SBP) using "VPS-HA" vitamin E-bonded super high-flux PS membrane dialyzers. The subjects were 62 diabetic HD patients whose intradialytic SBP fell by more than 20%. Group A comprised patients who required vasopressors to be able to continue treatment or who had to discontinue therapy due to their lowest intradialytic SBP being observed at 210 min (28 patients). Group B comprised patients who showed no symptoms and required no vasopressors but showed a gradual reduction in blood pressure, with the lowest intradialytic SBP seen at the end of dialysis (34 patients). The primary outcome was defined as the lowest intradialytic SBP after 3 months using VPS-HA. Secondary outcomes included changes in the following: lowest intradialytic diastolic blood pressure, pulse pressure, pulse rate, plasma nitric oxide and peroxynitrite, serum albumin, and hemoglobin A1c. Group A's lowest intradialytic SBP had significantly improved at 3 months (128.0 ± 25.1 mm Hg vs. 117.1 ± 29.2 mm Hg; P = 0.017). Group B's lowest intradialytic SBP had significantly improved at 1 month (134.4 ± 13.2 mm Hg vs. 121.5 ± 25.8 mm Hg; P = 0.047) and 3 months (139.1 ± 20.9 mm Hg vs. 121.5 ± 25.8 mm Hg; P = 0.011). We conclude that VPS-HA may improve IDH in diabetic HD patients.
© 2012, Copyright the Authors. Artificial Organs © 2012, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.
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References
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- Shoji T, Tsubakihara Y, Fujii M, et al. Hemodialysis-associated hypotension as an independent risk factor for two-year mortality in hemodialysis patients. Kidney Int. 2004;66:1212–20. - PubMed
-
- Japanese Society for Dialysis Therapy. An Overview of Regular Dialysis Treatment in Japan (as of 31 December 2001) Tokyo: Japanese Society for Dialysis Therapy; 2002. pp. 344–5. - PubMed
-
- Japanese Society for Dialysis Therapy. An Overview of Regular Dialysis Treatment in Japan (as of 31 December 2010) Tokyo: Japanese Society for Dialysis Therapy; 2011. p. 15. - PubMed
-
- Zou YL, Liu HL, Duan XF, et al. Impact of sodium and ultrafiltration profiling on haemodialysis-related hypotension. Nephrol Dial Transplant. 2006;11:3231–7. - PubMed
-
- Alappan R, Cruz D, Abu-alfa AK, et al. Treatment of severe intradialytic hypotension with the addition of high dialysate calcium concentration to midodrine and/or cool dialysate. Am J Kidney Dis. 2001;2:294–9. - PubMed
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