دورية أكاديمية

Acute Central Hemodynamic Effects of a Volume Exchange in Peritoneal Dialysis

التفاصيل البيبلوغرافية
العنوان: Acute Central Hemodynamic Effects of a Volume Exchange in Peritoneal Dialysis
المؤلفون: Verbeke, Francis, Van Biesen, Wim, Pletinck, Anneleen, Van Bortel, Luc M., Vanholder, Raymond
المصدر: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis ; volume 28, issue 2, page 142-148 ; ISSN 0896-8608 1718-4304
بيانات النشر: SAGE Publications
سنة النشر: 2008
مصطلحات موضوعية: Nephrology, General Medicine
الوصف: Background Although peritoneal dialysis is considered to offer more hemodynamic stability than hemodialysis, the acute hemodynamic effects of peritoneal dialysis have only been investigated scarcely. The present study assesses the central hemodynamic impact of volume infusion using pH-adjusted icodextrin, thus avoiding interference of glucose, pH, and osmolarity. Methods Patients were randomized to 3 different starting volumes (A: 1000 mL, B: 1500 mL, and C: 2500 mL) of icodextrin, followed by addition (A and B) or drainage (C) of 200 mL every 10 minutes for 50 minutes. Local carotid systolic blood pressure (BP; as a surrogate for central BP), augmentation index, and augmentation pressure were measured by applanation tonometry before and after infusion of the starting volumes and after each volume change. Results We included 13 patients (median age 57 years). Baseline brachial BP was 126/77 mmHg. After infusion of the starting volume, carotid systolic BP and augmentation pressure increased by 4.7 mmHg ( p = 0.006) and 3.1 mmHg ( p = 0.015). Augmentation index increased by 5.7% ( p = 0.04) and heart rate decreased by 2.6/minute ( p = 0.006). Intraperitoneal pressure increased by 2.3 cm H 2 O ( p = 0.03). No additional hemodynamic changes except for a rise in diastolic BP with increasing volume ( p = 0.004) were observed after subsequent addition or removal of volumes. Conclusions Infusion of peritoneal dialysis fluids causes an acute increase in carotid systolic B P, followed by a progressive rise in diastolic BP. These effects persist until complete drainage of the abdomen and may be due to an enhanced preload, resulting from intraperitoneal venous compression, and/or increased wave reflection.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1177/089686080802800209
الإتاحة: https://doi.org/10.1177/089686080802800209Test
حقوق: http://journals.sagepub.com/page/policies/text-and-data-mining-licenseTest
رقم الانضمام: edsbas.57D18C4C
قاعدة البيانات: BASE