Relative plasma volume monitoring during hemodialysis aids the assessment of dry weight

Arjun Sinha, Robert P. Light, Rajiv Agarwal

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

Among hemodialysis patients, the assessment of dry weight remains a matter of clinical judgment because tests to assess dry weight have not been validated. The objective of this study was to evaluate and validate relative plasma volume (RPV) monitoring as a marker of dry weight. We performed RPV monitoring using the Crit-Line monitor at baseline and at 8 weeks in 150 patients participating in the Dry-Weight Reduction in Hypertensive Hemodialysis Patients Trial. The intervention group of 100 patients had dry weight probed, whereas 50 patients served as time controls. RPV slopes were defined as flat when they were less than the median (1.33% per hour) at the baseline visit. Among predominantly (87%) black hemodialysis patients, we found that flat RPV slopes suggest a volume-overloaded state for the following reasons: (1) probing dry weight in these patients led to steeper slopes; (2) those with flatter slopes at baseline had greater weight loss; (3) both baseline RPV slopes and the intensity of weight loss were found to be important for subsequent change in RPV slopes; and, most importantly, (4) RPV slopes predicted the subsequent reduction in interdialytic ambulatory systolic blood pressure. Those with the flattest slopes had the greatest decline in blood pressure on probing dry weight. Both baseline RPV slopes and the change in RPV slopes were important for subsequent changes in ambulatory systolic blood pressure. We conclude that RPV slope monitoring is a valid method to assess dry weight among hypertensive hemodialysis patients.

Original languageEnglish
Pages (from-to)305-311
Number of pages7
JournalHypertension
Volume55
Issue number2
DOIs
StatePublished - Feb 2010

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Plasma Volume
Renal Dialysis
Weights and Measures
Blood Pressure
Weight Loss

Keywords

  • Diagnostic test
  • Dry weight
  • Hemodialysis
  • Hypertension
  • Plasma volume

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Relative plasma volume monitoring during hemodialysis aids the assessment of dry weight. / Sinha, Arjun; Light, Robert P.; Agarwal, Rajiv.

In: Hypertension, Vol. 55, No. 2, 02.2010, p. 305-311.

Research output: Contribution to journalArticle

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