The cardiovascular unphysiology of thrice weekly hemodialysis.
| Autor: | Shringi S; Warren Alpert Medical School of Brown University.; Division of Kidney Disease and Hypertension, Department of Medicine, Rhode Island Hospital, Providence, Rhode Island, USA., Shah AD; Warren Alpert Medical School of Brown University.; Division of Kidney Disease and Hypertension, Department of Medicine, Rhode Island Hospital, Providence, Rhode Island, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Current opinion in nephrology and hypertension [Curr Opin Nephrol Hypertens] 2025 Jan 01; Vol. 34 (1), pp. 69-76. Date of Electronic Publication: 2024 Nov 05. |
| DOI: | 10.1097/MNH.0000000000001037 |
| Abstrakt: | Purpose of Review: This review examines the unphysiological nature of conventional intermittent hemodialysis (IHD) and explores alternative dialysis modalities that more closely mimic natural kidney function. As cardiovascular complications remain a leading cause of morbidity and mortality in dialysis patients, understanding and addressing the limitations of IHD is crucial for improving outcomes. Recent Findings: IHD's intermittent nature leads to significant fluctuations in metabolites, electrolytes, and fluid status, contributing to hemodynamic instability and increased cardiovascular risk. More frequent dialysis modalities, such as short daily hemodialysis and nocturnal hemodialysis have numerous benefits including reduced left ventricular hypertrophy, improved blood pressure control, and potentially decreasing mortality. Peritoneal dialysis offers a more continuous approach to treatment, which may provide cardiovascular benefits through gentler fluid removal and residual kidney function preservation. Summary: Conventional thrice weekly intermittent hemodialysis offers a fundamentally unphysiologic equilibrium of uremic solutes. Alternate approaches have demonstrated cardiovascular benefits. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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