IMPACT OF PLASMA REFILL RATE/ULTRAFILTRATION RATE RATIO ON HEMODYNAMIC STABILITY DURING HEMODIALYSIS IN PATIENTS WITH ACUTE KIDNEY INJURY

E-Poster

https://storage.unitedwebnetwork.com/files/1099/ba3eaac461104e3289933b925e2a7c59.pdf

Abstract Title

First Name *

Brian

Last Name *

Garibay Vega

Co-author 1

Armando Vázquez Rangel drarmandovazquez@hotmail.com Instituto Nacional Cardiologia Nephrology Department Mexico City

Co-author 2

Luis García Benitez luisgarbet@gmail.com Facultad de Medicina UNAM Chief of research Mexico City

Co-author 3

Francisco Rodríguez Castellanos eugencast@gmail.com Instituto Nacional Cardiología Nephrology Department Mexico City

Co-author 4

Salvador Lopez Gil salvadorlgil@gmail.com Instituto Nacional de Cardiologia Nefrología Ciudad de mexico

Co-author 5

Co-author 6

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Co-author 15

Introduction

Hemodynamic monitoring during hemodialysis is generally based on measurements of blood pressure and heart rate, as well as continuous monitoring of hematocrit (relative blood volume), although none of these strategies have shown strong benefits on hospitalization or mortality outcomes. The measurement of the plasma refill rate/ultrafiltration rate (PRR/UFR) ratio has been studied in maintenance hemodialysis patients to predict intradialytic hypotension (IDH) events, finding a cut-off value of <0.3 as a risk factor and >0.9 as a protector. This has not been studied in patients with acute kidney injury (AKI).

Methods

We used a validated method to calculate the plasma refill rate using hematocrit and ultrafiltration data, in patients with AKI who required hemodialysis.

Results

30 patients with AKI were studied during their first hemodialysis session. The average ultrafiltration rate was 10 ± 3 ml/kg/hr. There were 21 episodes of IDH (drops of > 20 mmHg of systolic blood pressure). The average of PRR/UFR ratio in patients with IDH were 0.49, compared with 0.57 in patients without IDH although this association was not significant (p= 0.592). Figure 1 shows AUC value of 0.91, could be predicted IDH with a sensitivity of 33% and specificity of 77%.

Conclusions

In summary, we found PRR/UFR was not associated with IDH in AKI patients. However, using this tool may improve our understanding of hemodynamic changes during hemodialysis in this population. Although more studies are needed, monitoring PRR/UFR ratio could be implemented as a strategy to prevent hemodynamic instability

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