Oral intake during hemodialysis: Is there an association with intradialytic hypotension?

Oral intake (OI) of food and fluid has been associated with hypotension during hemodialysis (HD). Trials evaluating this relationship are small. The objective of this study was to quantify OI and to examine its association with hypotension during HD. This is a cross‐sectional retrospective chart rev...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Hemodialysis international 2008-01, Vol.12 (1), p.62-65
Hauptverfasser: BENAROIA, Mark, ILIESCU, Eduard A.
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 65
container_issue 1
container_start_page 62
container_title Hemodialysis international
container_volume 12
creator BENAROIA, Mark
ILIESCU, Eduard A.
description Oral intake (OI) of food and fluid has been associated with hypotension during hemodialysis (HD). Trials evaluating this relationship are small. The objective of this study was to quantify OI and to examine its association with hypotension during HD. This is a cross‐sectional retrospective chart review study of 3 consecutive HD runs (dialysate iCa=1.25 mmol/L) in 126 stable HD patients (n=378). For each run, the calculation for OI=total ultrafiltration−(net weight loss+IV fluids given). Hypotension was defined as a systolic blood pressure of
doi_str_mv 10.1111/j.1542-4758.2008.00242.x
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70294936</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>70294936</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4042-29478ae691cce8b4ace2764fd1a17e7fb3317ad5e380dad7d2d55695fb7d208d3</originalsourceid><addsrcrecordid>eNqNkFtrGzEQRkVpaG79C0VPfduNrittKZRiJ44hJBByexPyaraWs951pDWx_320sUlfoxcNzDkzw4cQpiSn6Z0tcioFy4SSOmeE6JwQJli--YKOPhpfUy1KlinJ5SE6jnGRIEpI8Q0dUs0U1YIfoaebYBvs294-A3br4Nt_eA7LznnbbKOPv_A04n4OAbBtsY2xq7ztfdfiV9_PBzHYd7b3FZ5vV10PbUztP6fooLZNhO_7_wTdX5zfjS6zq5vJdPT3KqsESZeyUihtoShpVYGeCVsBU4WoHbVUgapnnFNlnQSuibNOOeakLEpZz1JJtOMn6Odu7ip0L2uIvVn6WEHT2Ba6dTSKpBUlLxKod2AVuhgD1GYV_NKGraHEDKmahRnCM0N4ZkjVvKdqNkn9sd-xni3B_Rf3MSbg9w549Q1sPz3YXI6nqUh6ttN97GHzodvwbArFlTSP1xMzvqUPI86UmfA314SV_w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>70294936</pqid></control><display><type>article</type><title>Oral intake during hemodialysis: Is there an association with intradialytic hypotension?</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><creator>BENAROIA, Mark ; ILIESCU, Eduard A.</creator><creatorcontrib>BENAROIA, Mark ; ILIESCU, Eduard A.</creatorcontrib><description>Oral intake (OI) of food and fluid has been associated with hypotension during hemodialysis (HD). Trials evaluating this relationship are small. The objective of this study was to quantify OI and to examine its association with hypotension during HD. This is a cross‐sectional retrospective chart review study of 3 consecutive HD runs (dialysate iCa=1.25 mmol/L) in 126 stable HD patients (n=378). For each run, the calculation for OI=total ultrafiltration−(net weight loss+IV fluids given). Hypotension was defined as a systolic blood pressure of &lt;100 mmHg at any point during the run. The mean age of the patients was 60.9 years, 38.2% were female, 30.2% had diabetes mellitus, and the majority were Caucasian. The mean (SD) OI was 0.27 (0.352) L/run, range −1.061 to 1.901 L/run, with a normal distribution. In bivariate analysis, there was no correlation of OI with systolic blood pressure, diastolic blood pressure, or mean blood pressure (BP), and the mean OI did not differ among runs with hypotension (n=78) compared with uncomplicated runs (p=0.93). Oral intake was not predictive of hypotension in a multiple logistic regression model controlling for vintage, age, sex, BP medications, coronary disease, dialysis day and shift, diabetes mellitus, s‐Ca, Na and ultrafiltration profiles, and dialysis temperature, even when the analysis was restricted to runs where the patients reached the prescribed dry weight within 0.1 kg. The results of this study suggest that the mean OI during dialysis is just over 0.25 kg, with some patients consuming several kilograms. The clinical significance of OI is uncertain. We did not find an association between OI and hypotension. It is likely that this association was confounded by failure to achieve the prescribed dry weight in a proportion of patients with a high OI, as well as interventions implemented in response to hypotension in previous runs. For example, patients with previous episodes of low BP are advised to limit OI, are prescribed profiles, and so on. There may be other deleterious effects of high OI including hypertension and cardiac disease. The generalizability of the results of this largely Caucasian study population is a recognized limitation. Further prospective and blinded studies are needed to examine the association between OI and hypotension, the long‐term clinical consequences of OI, and to define thresholds for recommended OI during dialysis.</description><identifier>ISSN: 1492-7535</identifier><identifier>EISSN: 1542-4758</identifier><identifier>DOI: 10.1111/j.1542-4758.2008.00242.x</identifier><identifier>PMID: 18271843</identifier><language>eng</language><publisher>Malden, USA: Blackwell Publishing Inc</publisher><subject>Adult ; Aged ; Blood Pressure - physiology ; Cross-Sectional Studies ; Eating ; Female ; fluid intake in hemodialysis ; food intake in hemodialysis ; hemodialysis ; Humans ; Hypotension - epidemiology ; Hypotension - etiology ; Intradialytic hypotension ; Kidney Failure, Chronic - etiology ; Kidney Failure, Chronic - therapy ; Male ; Middle Aged ; Ontario ; Renal Dialysis - adverse effects ; Retrospective Studies ; Ultrafiltration</subject><ispartof>Hemodialysis international, 2008-01, Vol.12 (1), p.62-65</ispartof><rights>2008 The Authors</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4042-29478ae691cce8b4ace2764fd1a17e7fb3317ad5e380dad7d2d55695fb7d208d3</citedby><cites>FETCH-LOGICAL-c4042-29478ae691cce8b4ace2764fd1a17e7fb3317ad5e380dad7d2d55695fb7d208d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1542-4758.2008.00242.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1542-4758.2008.00242.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18271843$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>BENAROIA, Mark</creatorcontrib><creatorcontrib>ILIESCU, Eduard A.</creatorcontrib><title>Oral intake during hemodialysis: Is there an association with intradialytic hypotension?</title><title>Hemodialysis international</title><addtitle>Hemodial Int</addtitle><description>Oral intake (OI) of food and fluid has been associated with hypotension during hemodialysis (HD). Trials evaluating this relationship are small. The objective of this study was to quantify OI and to examine its association with hypotension during HD. This is a cross‐sectional retrospective chart review study of 3 consecutive HD runs (dialysate iCa=1.25 mmol/L) in 126 stable HD patients (n=378). For each run, the calculation for OI=total ultrafiltration−(net weight loss+IV fluids given). Hypotension was defined as a systolic blood pressure of &lt;100 mmHg at any point during the run. The mean age of the patients was 60.9 years, 38.2% were female, 30.2% had diabetes mellitus, and the majority were Caucasian. The mean (SD) OI was 0.27 (0.352) L/run, range −1.061 to 1.901 L/run, with a normal distribution. In bivariate analysis, there was no correlation of OI with systolic blood pressure, diastolic blood pressure, or mean blood pressure (BP), and the mean OI did not differ among runs with hypotension (n=78) compared with uncomplicated runs (p=0.93). Oral intake was not predictive of hypotension in a multiple logistic regression model controlling for vintage, age, sex, BP medications, coronary disease, dialysis day and shift, diabetes mellitus, s‐Ca, Na and ultrafiltration profiles, and dialysis temperature, even when the analysis was restricted to runs where the patients reached the prescribed dry weight within 0.1 kg. The results of this study suggest that the mean OI during dialysis is just over 0.25 kg, with some patients consuming several kilograms. The clinical significance of OI is uncertain. We did not find an association between OI and hypotension. It is likely that this association was confounded by failure to achieve the prescribed dry weight in a proportion of patients with a high OI, as well as interventions implemented in response to hypotension in previous runs. For example, patients with previous episodes of low BP are advised to limit OI, are prescribed profiles, and so on. There may be other deleterious effects of high OI including hypertension and cardiac disease. The generalizability of the results of this largely Caucasian study population is a recognized limitation. Further prospective and blinded studies are needed to examine the association between OI and hypotension, the long‐term clinical consequences of OI, and to define thresholds for recommended OI during dialysis.</description><subject>Adult</subject><subject>Aged</subject><subject>Blood Pressure - physiology</subject><subject>Cross-Sectional Studies</subject><subject>Eating</subject><subject>Female</subject><subject>fluid intake in hemodialysis</subject><subject>food intake in hemodialysis</subject><subject>hemodialysis</subject><subject>Humans</subject><subject>Hypotension - epidemiology</subject><subject>Hypotension - etiology</subject><subject>Intradialytic hypotension</subject><subject>Kidney Failure, Chronic - etiology</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Ontario</subject><subject>Renal Dialysis - adverse effects</subject><subject>Retrospective Studies</subject><subject>Ultrafiltration</subject><issn>1492-7535</issn><issn>1542-4758</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkFtrGzEQRkVpaG79C0VPfduNrittKZRiJ44hJBByexPyaraWs951pDWx_320sUlfoxcNzDkzw4cQpiSn6Z0tcioFy4SSOmeE6JwQJli--YKOPhpfUy1KlinJ5SE6jnGRIEpI8Q0dUs0U1YIfoaebYBvs294-A3br4Nt_eA7LznnbbKOPv_A04n4OAbBtsY2xq7ztfdfiV9_PBzHYd7b3FZ5vV10PbUztP6fooLZNhO_7_wTdX5zfjS6zq5vJdPT3KqsESZeyUihtoShpVYGeCVsBU4WoHbVUgapnnFNlnQSuibNOOeakLEpZz1JJtOMn6Odu7ip0L2uIvVn6WEHT2Ba6dTSKpBUlLxKod2AVuhgD1GYV_NKGraHEDKmahRnCM0N4ZkjVvKdqNkn9sd-xni3B_Rf3MSbg9w549Q1sPz3YXI6nqUh6ttN97GHzodvwbArFlTSP1xMzvqUPI86UmfA314SV_w</recordid><startdate>200801</startdate><enddate>200801</enddate><creator>BENAROIA, Mark</creator><creator>ILIESCU, Eduard A.</creator><general>Blackwell Publishing Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200801</creationdate><title>Oral intake during hemodialysis: Is there an association with intradialytic hypotension?</title><author>BENAROIA, Mark ; ILIESCU, Eduard A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4042-29478ae691cce8b4ace2764fd1a17e7fb3317ad5e380dad7d2d55695fb7d208d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Blood Pressure - physiology</topic><topic>Cross-Sectional Studies</topic><topic>Eating</topic><topic>Female</topic><topic>fluid intake in hemodialysis</topic><topic>food intake in hemodialysis</topic><topic>hemodialysis</topic><topic>Humans</topic><topic>Hypotension - epidemiology</topic><topic>Hypotension - etiology</topic><topic>Intradialytic hypotension</topic><topic>Kidney Failure, Chronic - etiology</topic><topic>Kidney Failure, Chronic - therapy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Ontario</topic><topic>Renal Dialysis - adverse effects</topic><topic>Retrospective Studies</topic><topic>Ultrafiltration</topic><toplevel>online_resources</toplevel><creatorcontrib>BENAROIA, Mark</creatorcontrib><creatorcontrib>ILIESCU, Eduard A.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Hemodialysis international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>BENAROIA, Mark</au><au>ILIESCU, Eduard A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Oral intake during hemodialysis: Is there an association with intradialytic hypotension?</atitle><jtitle>Hemodialysis international</jtitle><addtitle>Hemodial Int</addtitle><date>2008-01</date><risdate>2008</risdate><volume>12</volume><issue>1</issue><spage>62</spage><epage>65</epage><pages>62-65</pages><issn>1492-7535</issn><eissn>1542-4758</eissn><abstract>Oral intake (OI) of food and fluid has been associated with hypotension during hemodialysis (HD). Trials evaluating this relationship are small. The objective of this study was to quantify OI and to examine its association with hypotension during HD. This is a cross‐sectional retrospective chart review study of 3 consecutive HD runs (dialysate iCa=1.25 mmol/L) in 126 stable HD patients (n=378). For each run, the calculation for OI=total ultrafiltration−(net weight loss+IV fluids given). Hypotension was defined as a systolic blood pressure of &lt;100 mmHg at any point during the run. The mean age of the patients was 60.9 years, 38.2% were female, 30.2% had diabetes mellitus, and the majority were Caucasian. The mean (SD) OI was 0.27 (0.352) L/run, range −1.061 to 1.901 L/run, with a normal distribution. In bivariate analysis, there was no correlation of OI with systolic blood pressure, diastolic blood pressure, or mean blood pressure (BP), and the mean OI did not differ among runs with hypotension (n=78) compared with uncomplicated runs (p=0.93). Oral intake was not predictive of hypotension in a multiple logistic regression model controlling for vintage, age, sex, BP medications, coronary disease, dialysis day and shift, diabetes mellitus, s‐Ca, Na and ultrafiltration profiles, and dialysis temperature, even when the analysis was restricted to runs where the patients reached the prescribed dry weight within 0.1 kg. The results of this study suggest that the mean OI during dialysis is just over 0.25 kg, with some patients consuming several kilograms. The clinical significance of OI is uncertain. We did not find an association between OI and hypotension. It is likely that this association was confounded by failure to achieve the prescribed dry weight in a proportion of patients with a high OI, as well as interventions implemented in response to hypotension in previous runs. For example, patients with previous episodes of low BP are advised to limit OI, are prescribed profiles, and so on. There may be other deleterious effects of high OI including hypertension and cardiac disease. The generalizability of the results of this largely Caucasian study population is a recognized limitation. Further prospective and blinded studies are needed to examine the association between OI and hypotension, the long‐term clinical consequences of OI, and to define thresholds for recommended OI during dialysis.</abstract><cop>Malden, USA</cop><pub>Blackwell Publishing Inc</pub><pmid>18271843</pmid><doi>10.1111/j.1542-4758.2008.00242.x</doi><tpages>4</tpages></addata></record>
fulltext fulltext
identifier ISSN: 1492-7535
ispartof Hemodialysis international, 2008-01, Vol.12 (1), p.62-65
issn 1492-7535
1542-4758
language eng
recordid cdi_proquest_miscellaneous_70294936
source MEDLINE; Wiley Online Library All Journals
subjects Adult
Aged
Blood Pressure - physiology
Cross-Sectional Studies
Eating
Female
fluid intake in hemodialysis
food intake in hemodialysis
hemodialysis
Humans
Hypotension - epidemiology
Hypotension - etiology
Intradialytic hypotension
Kidney Failure, Chronic - etiology
Kidney Failure, Chronic - therapy
Male
Middle Aged
Ontario
Renal Dialysis - adverse effects
Retrospective Studies
Ultrafiltration
title Oral intake during hemodialysis: Is there an association with intradialytic hypotension?
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-12T03%3A12%3A06IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Oral%20intake%20during%20hemodialysis:%20Is%20there%20an%20association%20with%20intradialytic%20hypotension?&rft.jtitle=Hemodialysis%20international&rft.au=BENAROIA,%20Mark&rft.date=2008-01&rft.volume=12&rft.issue=1&rft.spage=62&rft.epage=65&rft.pages=62-65&rft.issn=1492-7535&rft.eissn=1542-4758&rft_id=info:doi/10.1111/j.1542-4758.2008.00242.x&rft_dat=%3Cproquest_cross%3E70294936%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=70294936&rft_id=info:pmid/18271843&rfr_iscdi=true