The first hour refill index: a promising marker of volume overload in children and young adults on chronic hemodialysis
Background Volume overload is a known risk factor for cardiovascular complications in children on hemodialysis (HD), but a measurable index of volume overload is still lacking. Methods We propose a novel index of pre-HD volume overload based on blood volume (BV) monitoring, the first hour refill ind...
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| Veröffentlicht in: | Pediatric nephrology (Berlin, West) West), 2018-07, Vol.33 (7), p.1209-1214 |
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| creator | Paglialonga, Fabio Consolo, Silvia Edefonti, Alberto Montini, Giovanni |
| description | Background
Volume overload is a known risk factor for cardiovascular complications in children on hemodialysis (HD), but a measurable index of volume overload is still lacking.
Methods
We propose a novel index of pre-HD volume overload based on blood volume (BV) monitoring, the first hour refill index (RI), calculated as the ratio between the ultrafiltration rate indexed for body weight during the first HD hour and the percent BV change at the first hour of the treatment. This parameter was retrospectively calculated in 121 sessions in 11 oligoanuric children and young adults on chronic HD, with median age 14.3 years (range 5.4–22.4), and its association with left-ventricular mass index, pre-HD blood pressure, and number of antihypertensive medications was evaluated.
Results
The median RI was 2.07 ml/kg/h/%. There was a significant correlation between RI and median LVMI (
r
0.66,
p
= 0.028), which was 53.4 g/m
2.7
(45.7–64) in patients with a median RI > 2, and 36.6 g/m
2.7
(24.9–47) in those with a median RI 2 than in those with a RI |
| doi_str_mv | 10.1007/s00467-018-3915-5 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2009568338</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A541564223</galeid><sourcerecordid>A541564223</sourcerecordid><originalsourceid>FETCH-LOGICAL-c508t-e5991aa8e44f785492e6431feaf740777c642d533f05421ce8f6c4d85e50a6383</originalsourceid><addsrcrecordid>eNp1kkFvFSEUhYnR2Gf1B7gxJCbGzVQYYIZx1zRWTZq4qUl3BOHyhspAhZnq-_fl9VVrzTMsWNzv3Nx77kHoJSVHlJD-XSGEd31DqGzYQEUjHqEV5axt6CAvHqMVGRhtCKcXB-hZKZeEEClk9xQdtAMf2q5nK_TzfATsfC4zHtOScQbnQ8A-Wvj1Hmt8ldPki49rPOn8HTJODl-nsEyA0zXkkLStMDajDzZDxDpavElL5bVdwlxw2hZzit7gEaZkvQ6b4stz9MTpUODF3X-Ivp5-OD_51Jx9-fj55PisMYLIuQExDFRrCZy7Xoo6NXScUQfa9Zz0fW863lrBmCOCt9SAdJ3hVgoQRHdMskP0dte3LvJjgTKruo6BEHSEtBTVEjKITrJb9PU_6GV1JNbpbqmWCSr6e2qtAygfXZqzNtum6lhwKuo8LatUs4daQ4SsQ4pbk-Ehf7SHr8_C5M1ewZu_BCPoMI-l3mX2KZaHIN2BJqdS6nnVVfb1lhtFidqmSO1SpGqK1DZFSlTNqzsnlm8T2D-K37GpQLsDSi3FNeR7q_7f9QY1fM9u</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2009235157</pqid></control><display><type>article</type><title>The first hour refill index: a promising marker of volume overload in children and young adults on chronic hemodialysis</title><source>SpringerNature Journals</source><creator>Paglialonga, Fabio ; Consolo, Silvia ; Edefonti, Alberto ; Montini, Giovanni</creator><creatorcontrib>Paglialonga, Fabio ; Consolo, Silvia ; Edefonti, Alberto ; Montini, Giovanni</creatorcontrib><description>Background
Volume overload is a known risk factor for cardiovascular complications in children on hemodialysis (HD), but a measurable index of volume overload is still lacking.
Methods
We propose a novel index of pre-HD volume overload based on blood volume (BV) monitoring, the first hour refill index (RI), calculated as the ratio between the ultrafiltration rate indexed for body weight during the first HD hour and the percent BV change at the first hour of the treatment. This parameter was retrospectively calculated in 121 sessions in 11 oligoanuric children and young adults on chronic HD, with median age 14.3 years (range 5.4–22.4), and its association with left-ventricular mass index, pre-HD blood pressure, and number of antihypertensive medications was evaluated.
Results
The median RI was 2.07 ml/kg/h/%. There was a significant correlation between RI and median LVMI (
r
0.66,
p
= 0.028), which was 53.4 g/m
2.7
(45.7–64) in patients with a median RI > 2, and 36.6 g/m
2.7
(24.9–47) in those with a median RI < 2 ml/kg/h/% (
p
= 0.01). The number of antihypertensive drugs per patient was significantly higher in patients with a RI > 2 than in those with a RI < 2 ml/kg/h/% (three vs one per patient;
p
= 0.02) while blood pressure was not significantly different between the two groups.
Conclusions
The ratio between the ultrafiltration rate per body weight and the BV change during the first hour of a HD session could be a promising index of refill capacity and pre-HD volume overload in children and young adults on chronic HD.</description><identifier>ISSN: 0931-041X</identifier><identifier>EISSN: 1432-198X</identifier><identifier>DOI: 10.1007/s00467-018-3915-5</identifier><identifier>PMID: 29492673</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Antihypertensives ; Blood pressure ; Body weight ; Cardiac output ; Cardiovascular diseases ; Care and treatment ; Children ; Chronic kidney failure ; Complications and side effects ; Health aspects ; Heart ; Hemodialysis ; Medicine ; Medicine & Public Health ; Nephrology ; Original Article ; Pediatric diseases ; Pediatrics ; Risk factors ; Ultrafiltration ; Urology ; Ventricle ; What's New in Dialysis ; Young adults</subject><ispartof>Pediatric nephrology (Berlin, West), 2018-07, Vol.33 (7), p.1209-1214</ispartof><rights>IPNA 2018</rights><rights>COPYRIGHT 2018 Springer</rights><rights>Pediatric Nephrology is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c508t-e5991aa8e44f785492e6431feaf740777c642d533f05421ce8f6c4d85e50a6383</citedby><cites>FETCH-LOGICAL-c508t-e5991aa8e44f785492e6431feaf740777c642d533f05421ce8f6c4d85e50a6383</cites><orcidid>0000-0002-9912-3371</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00467-018-3915-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00467-018-3915-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29492673$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Paglialonga, Fabio</creatorcontrib><creatorcontrib>Consolo, Silvia</creatorcontrib><creatorcontrib>Edefonti, Alberto</creatorcontrib><creatorcontrib>Montini, Giovanni</creatorcontrib><title>The first hour refill index: a promising marker of volume overload in children and young adults on chronic hemodialysis</title><title>Pediatric nephrology (Berlin, West)</title><addtitle>Pediatr Nephrol</addtitle><addtitle>Pediatr Nephrol</addtitle><description>Background
Volume overload is a known risk factor for cardiovascular complications in children on hemodialysis (HD), but a measurable index of volume overload is still lacking.
Methods
We propose a novel index of pre-HD volume overload based on blood volume (BV) monitoring, the first hour refill index (RI), calculated as the ratio between the ultrafiltration rate indexed for body weight during the first HD hour and the percent BV change at the first hour of the treatment. This parameter was retrospectively calculated in 121 sessions in 11 oligoanuric children and young adults on chronic HD, with median age 14.3 years (range 5.4–22.4), and its association with left-ventricular mass index, pre-HD blood pressure, and number of antihypertensive medications was evaluated.
Results
The median RI was 2.07 ml/kg/h/%. There was a significant correlation between RI and median LVMI (
r
0.66,
p
= 0.028), which was 53.4 g/m
2.7
(45.7–64) in patients with a median RI > 2, and 36.6 g/m
2.7
(24.9–47) in those with a median RI < 2 ml/kg/h/% (
p
= 0.01). The number of antihypertensive drugs per patient was significantly higher in patients with a RI > 2 than in those with a RI < 2 ml/kg/h/% (three vs one per patient;
p
= 0.02) while blood pressure was not significantly different between the two groups.
Conclusions
The ratio between the ultrafiltration rate per body weight and the BV change during the first hour of a HD session could be a promising index of refill capacity and pre-HD volume overload in children and young adults on chronic HD.</description><subject>Antihypertensives</subject><subject>Blood pressure</subject><subject>Body weight</subject><subject>Cardiac output</subject><subject>Cardiovascular diseases</subject><subject>Care and treatment</subject><subject>Children</subject><subject>Chronic kidney failure</subject><subject>Complications and side effects</subject><subject>Health aspects</subject><subject>Heart</subject><subject>Hemodialysis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nephrology</subject><subject>Original Article</subject><subject>Pediatric diseases</subject><subject>Pediatrics</subject><subject>Risk factors</subject><subject>Ultrafiltration</subject><subject>Urology</subject><subject>Ventricle</subject><subject>What's New in Dialysis</subject><subject>Young adults</subject><issn>0931-041X</issn><issn>1432-198X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kkFvFSEUhYnR2Gf1B7gxJCbGzVQYYIZx1zRWTZq4qUl3BOHyhspAhZnq-_fl9VVrzTMsWNzv3Nx77kHoJSVHlJD-XSGEd31DqGzYQEUjHqEV5axt6CAvHqMVGRhtCKcXB-hZKZeEEClk9xQdtAMf2q5nK_TzfATsfC4zHtOScQbnQ8A-Wvj1Hmt8ldPki49rPOn8HTJODl-nsEyA0zXkkLStMDajDzZDxDpavElL5bVdwlxw2hZzit7gEaZkvQ6b4stz9MTpUODF3X-Ivp5-OD_51Jx9-fj55PisMYLIuQExDFRrCZy7Xoo6NXScUQfa9Zz0fW863lrBmCOCt9SAdJ3hVgoQRHdMskP0dte3LvJjgTKruo6BEHSEtBTVEjKITrJb9PU_6GV1JNbpbqmWCSr6e2qtAygfXZqzNtum6lhwKuo8LatUs4daQ4SsQ4pbk-Ehf7SHr8_C5M1ewZu_BCPoMI-l3mX2KZaHIN2BJqdS6nnVVfb1lhtFidqmSO1SpGqK1DZFSlTNqzsnlm8T2D-K37GpQLsDSi3FNeR7q_7f9QY1fM9u</recordid><startdate>20180701</startdate><enddate>20180701</enddate><creator>Paglialonga, Fabio</creator><creator>Consolo, Silvia</creator><creator>Edefonti, Alberto</creator><creator>Montini, Giovanni</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9912-3371</orcidid></search><sort><creationdate>20180701</creationdate><title>The first hour refill index: a promising marker of volume overload in children and young adults on chronic hemodialysis</title><author>Paglialonga, Fabio ; Consolo, Silvia ; Edefonti, Alberto ; Montini, Giovanni</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c508t-e5991aa8e44f785492e6431feaf740777c642d533f05421ce8f6c4d85e50a6383</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Antihypertensives</topic><topic>Blood pressure</topic><topic>Body weight</topic><topic>Cardiac output</topic><topic>Cardiovascular diseases</topic><topic>Care and treatment</topic><topic>Children</topic><topic>Chronic kidney failure</topic><topic>Complications and side effects</topic><topic>Health aspects</topic><topic>Heart</topic><topic>Hemodialysis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nephrology</topic><topic>Original Article</topic><topic>Pediatric diseases</topic><topic>Pediatrics</topic><topic>Risk factors</topic><topic>Ultrafiltration</topic><topic>Urology</topic><topic>Ventricle</topic><topic>What's New in Dialysis</topic><topic>Young adults</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Paglialonga, Fabio</creatorcontrib><creatorcontrib>Consolo, Silvia</creatorcontrib><creatorcontrib>Edefonti, Alberto</creatorcontrib><creatorcontrib>Montini, Giovanni</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric nephrology (Berlin, West)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Paglialonga, Fabio</au><au>Consolo, Silvia</au><au>Edefonti, Alberto</au><au>Montini, Giovanni</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The first hour refill index: a promising marker of volume overload in children and young adults on chronic hemodialysis</atitle><jtitle>Pediatric nephrology (Berlin, West)</jtitle><stitle>Pediatr Nephrol</stitle><addtitle>Pediatr Nephrol</addtitle><date>2018-07-01</date><risdate>2018</risdate><volume>33</volume><issue>7</issue><spage>1209</spage><epage>1214</epage><pages>1209-1214</pages><issn>0931-041X</issn><eissn>1432-198X</eissn><abstract>Background
Volume overload is a known risk factor for cardiovascular complications in children on hemodialysis (HD), but a measurable index of volume overload is still lacking.
Methods
We propose a novel index of pre-HD volume overload based on blood volume (BV) monitoring, the first hour refill index (RI), calculated as the ratio between the ultrafiltration rate indexed for body weight during the first HD hour and the percent BV change at the first hour of the treatment. This parameter was retrospectively calculated in 121 sessions in 11 oligoanuric children and young adults on chronic HD, with median age 14.3 years (range 5.4–22.4), and its association with left-ventricular mass index, pre-HD blood pressure, and number of antihypertensive medications was evaluated.
Results
The median RI was 2.07 ml/kg/h/%. There was a significant correlation between RI and median LVMI (
r
0.66,
p
= 0.028), which was 53.4 g/m
2.7
(45.7–64) in patients with a median RI > 2, and 36.6 g/m
2.7
(24.9–47) in those with a median RI < 2 ml/kg/h/% (
p
= 0.01). The number of antihypertensive drugs per patient was significantly higher in patients with a RI > 2 than in those with a RI < 2 ml/kg/h/% (three vs one per patient;
p
= 0.02) while blood pressure was not significantly different between the two groups.
Conclusions
The ratio between the ultrafiltration rate per body weight and the BV change during the first hour of a HD session could be a promising index of refill capacity and pre-HD volume overload in children and young adults on chronic HD.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>29492673</pmid><doi>10.1007/s00467-018-3915-5</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-9912-3371</orcidid></addata></record> |
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| identifier | ISSN: 0931-041X |
| ispartof | Pediatric nephrology (Berlin, West), 2018-07, Vol.33 (7), p.1209-1214 |
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| language | eng |
| recordid | cdi_proquest_miscellaneous_2009568338 |
| source | SpringerNature Journals |
| subjects | Antihypertensives Blood pressure Body weight Cardiac output Cardiovascular diseases Care and treatment Children Chronic kidney failure Complications and side effects Health aspects Heart Hemodialysis Medicine Medicine & Public Health Nephrology Original Article Pediatric diseases Pediatrics Risk factors Ultrafiltration Urology Ventricle What's New in Dialysis Young adults |
| title | The first hour refill index: a promising marker of volume overload in children and young adults on chronic hemodialysis |
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