HEMODYNAMICS IN HEMOFILTRATION

  • 1 January 1983
    • journal article
    • research article
    • Vol. 6  (1) , 27-31
Abstract
To study the established but not well understood phenomenon of improved intratreatment vascular stability during hemofiltration the same 10 stable hemodialysis patients were investigated during 1 hemodialysis and 1 hemofiltration treatment. Both treatments were matched in regard to linear fluid withdrawal (3 kg/240 min), small molecule removal rate (Curea 120 ml/min). Na (140 meq/l) and acetate (35 meq/l) concentration in dialysate and replacement fluid were identical. Outcome measures included mean arterial blood pressure, total peripheral vascular resistance by thermodilution, plasma noradrenaline [norepinephrine] concentration as index of sympathetic activity and Na loss/treatment. Blood pressure was maintained during hemofiltration, while total peripheral vascular resistance and plasma noradrenaline concentrations increased. During hemodialysis mean arterial blood pressure fell significantly, total peripheral resistance and plasma noradrenaline concentrations remained unchanged. During both treatment modalities Na loss was comparable. The improved hemodynamic stability during hemofiltration apparently is due to a maintained physiologic response to ultrafiltration, which is impaired during hemodialysis. Vascular stability during hemofiltration is not due to Na retention relative to hemodialysis.