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      Call for Papers: Green Renal Replacement Therapy: Caring for the Environment

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      About Blood Purification: 3.0 Impact Factor I 5.6 CiteScore I 0.83 Scimago Journal & Country Rank (SJR)

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      Changes in heart rate variability in chronic uremic patients during ultrafiltration and hemodialysis.

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          Abstract

          The analysis of heart rate variability (HRV) is a useful tool to evaluate cardiac autonomic modulation, which is frequently impaired in chronic uremia.

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          Potassium Removal Increases the QTc Interval Dispersion during Hemodialysis

          Adamasco Cupisti, Fabio Galetta, Raffaele Caprioli … (1999)
          This study was planned to clarify the mechanism(s) by which hemodialysis increases the QTc dispersion, a marker of risk of ventricular arrhythmias. To this aim, 10 uremic patients, without any relevant heart diseases, underwent two different types of hemodialysis schedules. In the first, 1 h of isolated high rate ultrafiltration preceded the standard diffusive procedure. In the second, during the first hour of standard bicarbonate hemodialysis, the decrease of plasma potassium concentration was prevented by increasing K + concentration in the dialysate, according to its pre dialysis plasma levels. During the high rate ultrafiltration period, together with ECG signs of increased sympathetic nervous system activity and catecholamines secretion, the QTc dispersion did not change significantly. Instead, an evident increment was observed 1 h after the start of the diffusive hemodialysis, then slowly progressing until the end of the dialysis and finally returning to the pre dialysis values within 2 h after the end of the session. To the contrary, the increase of the QTc dispersion was totally blunted during a standard hemodialysis procedure in absence of plasma K + decrease, but appeared again when the K + dialysate fluid concentration was restored to 2 mmol/l. This study provides evidence that the increase of QTc dispersion occurring on hemodialysis is mainly related to the diffusive process, more precisely to the K + removal. This is one more reason to focus attention on K + removal rate especially when hemodialysis treatment is given in uremics affected by cardiac diseases with high risk of arrhythmias.
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            Long, slow dialysis.

            B Charra, C Chazot, G. Jean … (2000)
            Long slow hemodialysis (3 x 8 hours/week) has been used in Tassin for 30 years without significant change in the method. It provides excellent results in terms of morbidity and mortality. The better survival than usually reported on shorter dialysis is mainly due to lower cardiovascular mortality. The nutritional state of the patient is good, as well as the correction of anemia with low doses of EPO. But the main feature concerns blood pressure; hypertension is very well controlled without need for antihypertensive medications. The gentle ultrafiltration provided by a long session time associated with a low salt diet and a moderate interdialytic weight gain allows for normalization of the extracellular fluid space in most patients (dry weight) without important intradialytic morbidity. This low salt diet has paradoxically been forgotten in recent years while shortened dialysis time renders it more necessary than ever.
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              Does dialysis therapy improve autonomic and peripheral nervous system abnormalities in chronic uraemia?

              S Laaksonen, L Voipio-Pulkki, M Erkinjuntti … (2000)
              Autonomic nervous system (ANS) dysfunction and peripheral neuropathy occur in patients with chronic renal insufficiency. Adequate renal replacement therapy should prevent development or correct these abnormalities.
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                Author and article information

                Journal
                Journal ID (iso-abbrev): Blood Purif.
                Title: Blood purification
                Publisher: S. Karger AG
                ISSN: 0253-5068
                ISSN (Print): 0253-5068
                Publication date (Electronic): 2001
                Volume: 19
                Issue: 4
                Affiliations
                [1 ] Department of Internal Medicine, University of Pisa, Italy. fgaletta@int.med.unipi.it
                Article
                Publisher Item ID: 46970
                DOI: 10.1159/000046970
                PubMed ID: 11574736
                SO-VID: eab1487d-7d97-4d34-8d31-4a692fc89ff1
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