Abstract for presentation at Australia and New Zealand Society of Nephrology Annual Scientific Conference

Introduction Intradialytic hypotension is the most common complication associated with chronic haemodialysis. Even if asymptomatic, such events can produce hypoxia in vital organs, contributing to morbidity and mortality. Ultrafiltration leading to intravascular hypovolaemia combined with poor cardiac and vascular compliance are the main factors influencing blood pressure during treatment. On-line blood volume monitoring devices (BVM) that monitor relative blood volume (RBV) have been shown to improve intradialytic hemodynamic stability. Such treatment profiles are advocated for patients who have multiple intradialytic events (IDEs).
Methods Nine hypotension-prone patients from a single dialysis centre were enrolled, and received firstly conventional and then control BVM haemodialysis, with each treatment arm lasting three months. Usual haemodialysis parameters were monitored; dry weight was established prior to commencement. All IDEs were recorded (including the presence of symptoms and/or BP fall >25mmHg), and therapeutic interventions noted.
Results There were 79 conventional and 74 BVM sessions. Five BVM sessions were abandoned due to technical failure. One patient was withdrawn due to illness. There was no difference between the two treatments in terms of haemodialysis profiles, haematinic parameters, albumin and medications. Control BVM did not demonstrate a lower rate of IDEs. The most common IDE was asymptomatic hypotension. Interdialytic weight gain and intradialytic weight loss, pre- and post- dialysis BP, RBV, and Kt/V were not significantly different between the two treatments (Table 1).
Conclusions No substantial improvement in haemodialysis blood pressure stability was demonstrated following the use of control BVM in this small group of hypotension-prone patients.