Clinical kidney journal · 2025
Effectiveness of blood volume change-guided ultrafiltration control (BV-UFC) in hemodialysis: a crossover comparative study.
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Hamada Shintaro, Hata Masami, Furukawa Shuntaro, Yamamoto Sunao
Аннотация
BACKGROUND AND HYPOTHESIS: Intradialytic hypotension (IDH), a common hemodialysis (HD) complication, increases cardiovascular risks and affects prognosis. Rapid ultrafiltration (UF) is a key factor. The blood volume change-guided ultrafiltration control (BV-UFC) system, which adjusts UF rates based on real-time blood volume (BV) monitoring, aims to enhance hemodynamic stability and reduce IDH.
METHODS: A 6-week crossover trial compared BV-UFC and standard HD in reducing IDH. Patients underwent 2 weeks of each treatment. The primary outcome was the frequency of IDH episodes. Secondary outcomes were plasma refilling rate (PRR) and target UF volume achievement.
RESULTS: This study included 38 patients, with 31 patients completing the trial. The frequency of IDH episodes was significantly reduced in patients using the BV-UFC system (P = .019). HD sessions with BV-UFC system showed a significantly higher PRR throughout the treatment session, particularly during the first 0-1 h and 1-2 h of treatment (P = .019, P < .001, P < .001), as compared with standard HD and the target UF volume was consistently higher in the BV-UFC sessions (P < .01).
CONCLUSION: The BV-UFC system effectively reduced the incidence of IDH by automatically adjusting the UF rate based on BV, without compromising treatment safety or UF volume. These findings suggest that BV-UFC can enhance hemodynamic stability and improve dialysis outcomes in patients undergoing HD (jRCT Study No. jRCT1062230034, registration date: 1 July 2023).
METHODS: A 6-week crossover trial compared BV-UFC and standard HD in reducing IDH. Patients underwent 2 weeks of each treatment. The primary outcome was the frequency of IDH episodes. Secondary outcomes were plasma refilling rate (PRR) and target UF volume achievement.
RESULTS: This study included 38 patients, with 31 patients completing the trial. The frequency of IDH episodes was significantly reduced in patients using the BV-UFC system (P = .019). HD sessions with BV-UFC system showed a significantly higher PRR throughout the treatment session, particularly during the first 0-1 h and 1-2 h of treatment (P = .019, P < .001, P < .001), as compared with standard HD and the target UF volume was consistently higher in the BV-UFC sessions (P < .01).
CONCLUSION: The BV-UFC system effectively reduced the incidence of IDH by automatically adjusting the UF rate based on BV, without compromising treatment safety or UF volume. These findings suggest that BV-UFC can enhance hemodynamic stability and improve dialysis outcomes in patients undergoing HD (jRCT Study No. jRCT1062230034, registration date: 1 July 2023).