Blood pressure and volume management in dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference
| Autor: | Jennifer E. Flythe, Tara I. Chang, Martin P. Gallagher, Elizabeth Lindley, Magdalena Madero, Pantelis A. Sarafidis, Mark L. Unruh, Angela Yee-Moon Wang, Daniel E. Weiner, Michael Cheung, Michel Jadoul, Wolfgang C. Winkelmayer, Kevan R. Polkinghorne, Teresa Adragão, Samaya J. Anumudu, Christopher T. Chan, Alfred K. Cheung, Maria Rosa Costanzo, Indranil Dasgupta, Andrew Davenport, Simon J. Davies, Marijke J.E. Dekker, Laura M. Dember, Daniel Gallego, Rafael Gómez, Carmel M. Hawley, Manfred Hecking, Kunitoshi Iseki, Vivekanand Jha, Jeroen P. Kooman, Csaba P. Kovesdy, Eduardo Lacson, Adrian Liew, Charmaine E. Lok, Christopher W. McIntyre, Rajnish Mehrotra, Dana C. Miskulin, Ezio Movilli, Fabio Paglialonga, Roberto Pecoits-Filho, Jeff Perl, Carol A. Pollock, Miguel C. Riella, Patrick Rossignol, Rukshana Shroff, Laura Solá, Henning Søndergaard, Sydney C.W. Tang, Allison Tong, Yusuke Tsukamoto, Suzanne Watnick, Matthew R. Weir, James B. Wetmore, Caroline Wilkie, Martin Wilkie |
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| Přispěvatelé: | University of North Carolina [Chapel Hill] (UNC), University of North Carolina System (UNC), Stanford School of Medicine [Stanford], Stanford Medicine, Stanford University-Stanford University, The George Institute for Global Health [Sydney] (GIGH), The University of Sydney, Concord Repatriation General Hospital [Sydney, Australia] (CRGH), Leeds Teaching Hospitals NHS Trust, Instituto Nacional de Cardiologia Ignacio Chavez, Aristotle University of Thessaloniki, The University of New Mexico [Albuquerque], The University of Hong Kong (HKU), Tufts Medical Center [Boston], KDIGO, Cliniques Universitaires Saint-Luc [Bruxelles], Université Catholique de Louvain = Catholic University of Louvain (UCL), Baylor College of Medicine (BCM), Baylor University, Monash University [Clayton], Baylor College of Medecine, York University [Toronto], Australian Catholic University (ACU), Institut de Gestion de Rennes - Institut d'Administration des Entreprises - Rennes (IGR-IAE Rennes), Université de Rennes (UR), University of Delhi, University College of London [London] (UCL), Perelman School of Medicine, University of Pennsylvania, Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre d'investigation clinique plurithématique Pierre Drouin [Nancy] (CIC-P), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy] (INI-CRCT), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], French-Clinical Research Infrastructure Network - F-CRIN [Paris] (Cardiovascular & Renal Clinical Trialists - CRCT ), UCL - SSS/IREC/NEFR - Pôle de Néphrologie, UCL - (SLuc) Service de néphrologie |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty medicine.medical_treatment 030232 urology & nephrology Psychological intervention Article Peritoneal dialysis 03 medical and health sciences 0302 clinical medicine Quality of life (healthcare) residual kidney function [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system medicine Medical prescription Intensive care medicine Dialysis patient-reported outcome measures hemodialysis business.industry medicine.disease 030104 developmental biology Blood pressure peritoneal dialysis quality of life Nephrology Hemodialysis business Kidney disease |
| Zdroj: | Kidney international Kidney International Kidney International, 2020, 97 (5), pp.861-876. ⟨10.1016/j.kint.2020.01.046⟩ Kidney International, Vol. 87, no. 5, p. 861-876 (2020) |
| ISSN: | 1523-1755 0085-2538 |
| DOI: | 10.1016/j.kint.2020.01.046⟩ |
| Popis: | International audience; Blood pressure (BP) and volume control are critical components of dialysis care and have substantial impacts on patient symptoms, quality of life, and cardiovascular complications. Yet, developing consensus best practices for BP and volume control have been challenging, given the absence of objective measures of extracellular volume status and the lack of high-quality evidence for many therapeutic interventions. In February of 2019, Kidney Disease: Improving Global Outcomes (KDIGO) held a Controversies Conference titled Blood Pressure and Volume Management in Dialysis to assess the current state of knowledge related to BP and volume management and identify opportunities to improve clinical and patient-reported outcomes among individuals receiving maintenance dialysis. Four major topics were addressed: BP measurement, BP targets, and pharmacologic management of suboptimal BP; dialysis prescriptions as they relate to BP and volume; extracellular volume assessment and management with a focus on technology-based solutions; and volume-related patient symptoms and experiences. The overarching theme resulting from presentations and discussions was that managing BP and volume in dialysis involves weighing multiple clinical factors and risk considerations as well as patient lifestyle and preferences, all within a narrow therapeutic window for avoiding acute or chronic volume-related complications. Striking this challenging balance requires individualizing the dialysis prescription by incorporating comorbid health conditions, treatment hemodynamic patterns, clinical judgment, and patient preferences into decision-making, all within local resource constraints. |
| Databáze: | OpenAIRE |
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