1. Ultrafiltration intensification in hemodialysis patients improves hypertension but increases AV fistula complications and cardiovascular events
- Author
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Graziella Caridi, Carmine Zoccali, Giovanni Tripepi, Davide Bolignano, Stefania Rastelli, Raffaele Politi, Francesco Catalano, Francesca Mallamaci, Maurizio Ciccarelli, Diego Delfino, Giuseppe Curatola, and Rocco Tripepi
- Subjects
Adult ,Male ,medicine.medical_specialty ,Fistula ,medicine.medical_treatment ,Population ,Ultrafiltration ,Blood Pressure ,Hemodiafiltration ,Arteriovenous Shunt, Surgical ,Patient Education as Topic ,Renal Dialysis ,Internal medicine ,Humans ,Medicine ,Salt intake ,education ,Aged ,education.field_of_study ,business.industry ,Extracellular Fluid ,Diet, Sodium-Restricted ,Middle Aged ,medicine.disease ,Hospitalization ,Blood pressure ,Cardiovascular Diseases ,Nephrology ,Relative risk ,Hypertension ,Cardiology ,Kidney Failure, Chronic ,Female ,Hemodialysis ,business ,Complication - Abstract
INTRODUCTION Hypertension remains a major problem in hemodialysis (HD) patients. METHODS We performed a pragmatic trial (Pragmatic Clinical Intervention on Blood Pressure Driven by Audit [CLINIDEA]) testing the effectiveness and safety of a 6-month multimodal intervention in hypertensive HD patients regarding the application of higher ultrafiltration (UF) rates or longer or more frequent dialyses in UF-intolerant patients, and an educational intervention to encourage patients to lower their salt and fluid intake. RESULTS Blood pressure (BP) in hypertensive patients (n=32) fell from 156.8 ± 13.3 / 81.1 ± 8.9 mm Hg to 147.9 ± 18.8 / 77.5 ± 11.1 mm Hg. UF intensification was well tolerated, and the BP goal was achieved without resorting to longer or more frequent dialyses. BP changes were paralleled by a consistent (p
- Published
- 2011
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