PMID- 11328906
OWN - NLM
STAT- MEDLINE
DCOM- 20010705
LR  - 20190513
IS  - 0931-0509 (Print)
IS  - 0931-0509 (Linking)
VI  - 16
IP  - 5
DP  - 2001 May
TI  - Effect of ultrafiltration on peripheral urea sequestration in haemodialysis 
      patients.
PG  - 994-8
AB  - BACKGROUND: Ultrafiltration (UF) is assumed to enhance urea removal during 
      haemodialysis (HD) because of convective transport and because of contraction of 
      urea distribution volume. However, UF-induced blood volume reduction has been 
      hypothesized to enhance peripheral urea sequestration and post-dialysis urea 
      rebound (PDUR), possibly reducing HD effectiveness. The effect of UF on PDUR was 
      investigated in this study. METHODS: Nine HD patients were studied on two 
      subsequent treatment days. The first HD was performed with UF 
      (UF-rate=0.78+/-0.27 l/h), and the second treatment without UF. Serial 
      measurements of serum water urea nitrogen concentration, arterial blood pressures 
      (BP), and relative blood volume changes (BV%) were obtained over the duration of 
      HD. RESULTS: BP and BV% decreased with UF (BP(sys)= -9%, BP(dia)=-8%, 
      BP(mean)=-9%, BV%=-15%) but increased or remained unchanged without UF (BP(sys)= 
      9%, BP(dia)=12%, BP(mean)=11%, BV%=1%). PDUR was 28.6+/-9.6% without UF, and 
      increased in every single patient with UF (40.7+/-13.2%, P<0.01). Modelled 
      perfusion of the peripheral low-flow compartment decreased from 1.45+/-0.54 l/min 
      without UF to 0.91+/-42 l/min with UF (P<0.05), thereby explaining an enhanced 
      two-compartment effect and increasing PDUR. CONCLUSION: The significant increase 
      in the two-compartment effect of urea kinetics observed in current HD accompanied 
      by UF can be explained by compensatory, intradialytic blood flow redistribution 
      induced by blood volume reduction. Because of the link between UF and blood flow, 
      limited solute clearance treatment modes that optimize fluid removal such as 
      variable UF will also have favourable effects on delivered dose of dialysis.
FAU - Schneditz, D
AU  - Schneditz D
AD  - Renal Research Institute, New York, NY, USA.
FAU - Zaluska, W T
AU  - Zaluska WT
FAU - Morris, A T
AU  - Morris AT
FAU - Levin, N W
AU  - Levin NW
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Nephrol Dial Transplant
JT  - Nephrology, dialysis, transplantation : official publication of the European 
      Dialysis and Transplant Association - European Renal Association
JID - 8706402
RN  - 8W8T17847W (Urea)
SB  - IM
MH  - Blood Pressure
MH  - Blood Volume
MH  - Humans
MH  - Models, Biological
MH  - *Renal Dialysis
MH  - *Ultrafiltration
MH  - Urea/*blood
EDAT- 2001/05/01 10:00
MHDA- 2001/07/06 10:01
CRDT- 2001/05/01 10:00
PHST- 2001/05/01 10:00 [pubmed]
PHST- 2001/07/06 10:01 [medline]
PHST- 2001/05/01 10:00 [entrez]
AID - 10.1093/ndt/16.5.994 [doi]
PST - ppublish
SO  - Nephrol Dial Transplant. 2001 May;16(5):994-8. doi: 10.1093/ndt/16.5.994.