Premium
Beneficial effects of nocturnal hemodialysis in a hemodynamically unstable patient with AL ‐amyloidosis
Author(s) -
Trigka Konstantina,
Dousdampanis Periklis,
Chan Christopher T.
Publication year - 2013
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/j.1542-4758.2012.00712.x
Subject(s) - medicine , hemodialysis , tolerability , amyloidosis , discontinuation , hemodynamics , cardiology , intensive care medicine , blood pressure , adverse effect
We present a patient with primary systemic AL ‐amyloidosis, who stabilized hemodynamically on nocturnal hemodialysis ( NHD ). The NHD allowed a significant reduction in ultrafiltration rates which likely underlies the procedural tolerability. It also provided an increase in urea clearance, better control of serum phosphorus levels without the use of any binders, and normalization of blood pressure despite the discontinuation of all antihypertensive agents. Given the autonomic derangements associated with AL ‐amyloidosis pathophysiology and the clinical benefits of NHD on hemodynamic stability, the use of intensive hemodialysis may be considered for the management of patients with unstable hemodynamic profiles.