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The impact of dialysis modality and membrane characteristics on intradialytic hypotension
Author(s) -
Patel Samir,
Raimann Jochen G.,
Kotanko Peter
Publication year - 2017
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/sdi.12636
Subject(s) - medicine , dialysis , hemodialysis , bicarbonate , treatment modality , modality (human–computer interaction) , randomized controlled trial , intensive care medicine , urology , surgery , computer science , human–computer interaction
The risk of intradialytic hypotension ( IDH ) is determined by various factors, among them dialysis modality and dialyzer membrane. We conducted a literature search in PubMed on November 1, 2016 and selected relevant randomized controlled and cross‐over trials, and prospective and retrospective cohort studies published in English that investigated the association between IDH and dialysis modality and membrane, respectively. This literature search revealed 669 publications on dialysis modality, 64 on dialysis membrane, and 24 on acetate/bicarbonate dialysate. After omission of duplicate papers and publications outside the scope of this review, we selected 34 papers for inclusion, 19 on dialysis modality, 8 on dialyzer membrane, and 7 on acetate/bicarbonate dialysate. Several strands of evidence indicate that hemodiafiltration ( HDF ) is associated with lower IDH rates compared to hemodialysis ( HD ). Data do not show an unequivocal benefit of synthetic vs nonsynthetic dialyzer membranes with respect to IDH occurrence. Acetate‐based vs bicarbonate‐based dialysate appears to be associated with an increased IDH rate .