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Editorial
. 2024 Mar 1;19(3):283-285.
doi: 10.2215/CJN.0000000000000408. Epub 2024 Jan 24.

Mechanistic Basis for Intradialytic Hypertension with Hemodialysis

Manfred Hecking  1   2   3 , Sebastian Mussnig  1   2 , Charles Chazot  4   5
Affiliations
Editorial

Mechanistic Basis for Intradialytic Hypertension with Hemodialysis

Manfred Hecking et al. Clin J Am Soc Nephrol. .
No abstract available

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Conflict of interest statement

M. Hecking reports employment with Kuratorium for Dialysis and Transplantation Germany; research funding from Astellas Pharma, Boehringer Ingelheim, Eli Lilly, and Siemens Healthcare; and honoraria from Bayer AG, Fresenius Medical Care, Janssen-Cilag, and Vifor. M. Hecking has served as a speaker and/or consultant for Astellas Pharma, AstraZeneca, Eli Lilly, Fresenius Medical Care, Janssen-Cilag, Siemens Healthcare, and Vifor and has previously received academic study support from Astellas Pharma, Boehringer Ingelheim, Eli Lilly, Nikkiso, and Siemens Healthcare (not related to the present work). All remaining authors have nothing to disclose.

Figures

Figure 1
Figure 1
Setup, signal, R–X graph, and confidence ellipses of bioimpedance measurements. (A) A typical setup for bioimpedance measurements with two current carrying electrodes (red) and two sensing electrodes (blue). (B) Schematically shows the sinewaves of current and voltage that are phase-shifted by θ (phase angle). (C) Illustrates the representation of the complex impedance value in the resistance–reactance graph and in vector form. Vector length and phase angle must not be interpreted separately, but should always be regarded as one value (which they are per definition). (D) Represents the idea behind the 50%, 75%, and 95% confidence ellipses for impedance vectors standardized by body height according to Piccoli et al. The upper and lower pole of the confidence ellipse include fluid-depleted and fluid-overloaded patients, respectively, while the left and right poles are more dependent on cell mass (left: obese and athletic; right: cachectic and anorexic). Piccoli suggested that stable patients receiving hemodialysis with relatively short vectors may be brought to euvolemia by adapting ultrafiltration prescription if their phase angle is otherwise within the target range. In patients with phase angles on the edge of the confidence ellipse, however, focus on ultrafiltration alone is not expected to solve the issue, but rather will require nutritional treatment as well. Such additional information might allow for more accurate description and treatment of hemodialysis subgroups in the future. j, imaginary unit; θ, phase angle; R, resistance; V, voltage; X, reactance; Z, impedance; |Z|, impedance magnitude.
See this image and copyright information in PMC

Comment on

References

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