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Review Current Fluid Management Findings and Publications

 

 

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Profile A

An "A" profile indicates that the patient's plasma refill rate is occurring at the same or a greater rate than ultrafiltration. This profile suggests that the ultrafiltration rate might be increased without immediate risk of intradialytic symptoms.

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Profile B

A "B" profile is a gradual slope that has been targeted to find the best compromise between a high ultrafiltration rate and the prevention of intradialytic symptoms. The ideal slope is not a fixed percentage of change in BV, and will vary from patient to patient.

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Profile C

A "C" profile is represented by a steep slope which indicates a rapid decrease in blood volume, and bears a higher risk for intradialytic symptoms such as lightheadedness, nausea, vomiting, cramping or hypotension.

 

Fluid Management Findings

Key Findings from Publications:

  • Therapy guided by Relative Plasma Volume (RPV) slope may serve as a valid tool to better achieve target weight using augmented reduction therapy among hemodialysis patients.2
  • RPV monitoring yields information that is prognostically important and independent of several risk factors including UF volume, aggressiveness of UF and interdialytic ambulatory blood pressure.3
  • RPV monitoring can assist in better achieving target weight.4
  • RPV has been used to find the best compromise between a high ultrafiltration rate and the prevention of intradialytic symptoms.2,5,6,7,8,9

 

  1. Agarwal, R, Alborzi, P, Satayan, S. Light RP “Dry-weight Reduction in Hypertensive Hemodialysis Patients (DRIP): A Randomized , Controlled Trial.” Hypertension 53 no. 3 (2009) 500-507.
  2. Sinha AD, Light RP, Agarwal R: “Relative Plasma Volume Monitoring During Hemodialysis Aids the Assessment of Dry Weight.” Hypertension 55 (2010): 305-3110. 
  3. Agarwal, R. “Hypervolemia is Associated With Increased Mortality Among Hemodialysis Patients.” Hypertension 56 (2010): 512-517. 
  4. Agarwal, R, Alborzi, P, Satayan, S. Light RP “Dry-weight Reduction in Hypertensive Hemodialysis Patients (DRIP): A Randomized , Controlled Trial.” Hypertension 53 (2009): 500-507. 
  5. Rodriguez HJ, Domenici R, Diroll A, Goykhman I. “Assessment of Dry Weight by Monitoring Changes in Blood Volume During Hemodialysis using Crit-Line.” Kidney Int 68 (2005): 854-861. 
  6. Goldstein S, Smith C, Currier H. “Non-invasive Interventions to Decrease Hospitalization and Associated Costs for Pediatric Patients Receiving Hemodialysis.” JASN 14 (2003), 2127-2131. 
  7. Michael M, Brewer ED, Goldstein SL. “Blood Volume Monitoring to Achieve Target Weight in Pediatric Hemodialysis Patients” Pediatri Nephrol 19 no. 4 (2004) 432-437. 
  8. Reddan, DN, Szczech LA et al. “Intradialytic Blood Volume Monitoring in Ambulatory Hemodialysis Patients: A Randomized Trial” J Am Soc Nephrol 16 (2005): 2162-2169. 
  9. Jain SR, Smith L, Brewer ED, Goldstein SL. “Non-invasive Intravascular Monitoring in the Pediatric Hemodialysis Population” Pediatri Nephrol < 18 no. 1 (2001) 15-8.


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