Does pausing ultrafiltration as a treatment for intradialytic hypotension cause backfiltration in hemodialysis?

Ultrafiltration is part of the hemodialysis procedure and can also be used exclusively to remove additional fluid in patients with fluid overload. Ultrafiltration that is too aggressive can result in hypotension, cramping, or other untoward effects. Temporarily pausing the ultrafiltration process is a technique used to help manage the adverse effects of rapid fluid removal. Some nurses prefer not to pause ultrafiltration because of the concern for backfiltration, and they elect to manage hypotension and cramping by normal saline infusions or other interventions. This article reviews the evidence to answer the following question submitted to the Exploring the Evidence Nephrology Nursing Journal Column: "Does pausing ultrafiltration as a treatment for intradialytic hypotension cause backfiltration"?