HIGH-PERFORMANCE HEMODIAFILTRATION AND BLOOD-PRESSURE STABILITY

In the present study, we have estimated plasma nonrefilling rate and a ssessed its relationship to blood pressure stability during hemodialys is (HD) with normal or high sodium dialysate and during high flux hemo diafiltration (HDF). In standard HD, the greater plasma nonrefilling r ate resulted in the larger decrease in blood pressure (alpha = -6.7 +/ - 0.2 mm Hg/%, p < 0.01, n = 75). When compared to standard HD, high f lux HDF(n = 6) altered neither plasma refilling nor blood pressure sta bility. Finally, the restrictive usage of high sodium dialysate reduce d plasma nonrefilling rate (21 +/- 3 vs. 16 +/- 2%, p < 0.05, n = 10) and the magnitude of decrease in blood pressure (16 +/- 6 vs. 9 +/- 4 mm Hg, p < 0.05) without increase in interdialytic weight gain. Our da ta indicate relative safety of high performance HDF, and warrant judic ious use of high sodium dialysate for the HD patients with hypotensive episodes.