Effect of a plasma sodium biofeedback system applied to HFR on the intradialytic cardiovascular stability. Results from a randomized controlled study

Francesco Locatelli, Sergio Stefoni, Thierry Petitclerc, Luigi Colì, Salvatore Di Filippo, Simeone Andrulli, Christine Fumeron, Giovanni Maria Frascà, Sibilla Sagripanti, Silvana Savoldi, Andrea Serra, Carmine Stallone, Filippo Aucella, Antonio Gesuete, Antonio Scarlatella, Francesco Quarello, Paola Mesiano, Peter Ahrenholz, Roland Winkler, Lise MandartJoan Fort, Christian Tielemans, Carlo Navino

Research output: Contribution to journalArticlepeer-review

Abstract

BackgroundIntradialytic hypotension (IDH) is still a major clinical problem for haemodialysis (HD) patients. Haemodiafiltration (HDF) has been shown to be able to reduce the incidence of IDH.MethodsFifty patients were enrolled in a prospective, randomized, crossover international study focussed on a variant of traditional HDF, haemofiltration with endogenous reinfusion (HFR). After a 1-month run-in period on HFR, the patients were randomized to two treatments of 2 months duration: HFR (Period A) or HFR-Aequilibrium (Period B), followed by a 1-month HFR wash-out period and then switched to the other treatment. HFR-Aequilibrium (HFR-Aeq) is an evolution of the haemofiltration with endogenous reinfusion (HFR) dialysis therapy, with dialysate sodium concentration and ultrafiltration rate profiles elaborated by an automated procedure. The primary end point was the frequency of IDH.ResultsSymptomatic hypotension episodes were significantly lower on HFR-Aeq versus HFR (23 ± 3 versus 31 ± 4 of sessions, respectively, P l l0.03), as was the per cent of clinical interventions (17 ± 3 of sessions with almost one intervention on HFR-Aeq versus 22 ± 2 on HFR, P a measure, can significantly reduce the burden of IDH. This could have an important impact in every day dialysis practice.

Original languageEnglish
Pages (from-to)3935-3942
Number of pages8
JournalNephrology Dialysis Transplantation
Volume27
Issue number10
DOIs
Publication statusPublished - Oct 2012

Keywords

  • biofeedback
  • intradialytic hypotension
  • sodium online measure

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

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