Blood pressure and volume management in dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference - Université de Lorraine Access content directly
Journal Articles Kidney International Year : 2020

Blood pressure and volume management in dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Tara I Chang
Michael Cheung
  • Function : Author
Teresa Adragão
  • Function : Author
Alfred Cheung
  • Function : Author
Maria Rosa Costanzo
  • Function : Author
Simon Davies
  • Function : Author
Marijke J.E. Dekker
  • Function : Author
Daniel Gallego
  • Function : Author
Rafael Gómez
  • Function : Author
Carmel Hawley
  • Function : Author
Manfred Hecking
  • Function : Author
Kunitoshi Iseki
  • Function : Author
Vivekanand Jha
  • Function : Author
Jeroen Kooman
  • Function : Author
Csaba Kovesdy
  • Function : Author
Eduardo Lacson
  • Function : Author
Adrian Liew
  • Function : Author
Charmaine Lok
  • Function : Author
Christopher Mcintyre
  • Function : Author
Rajnish Mehrotra
  • Function : Author
Dana Miskulin
  • Function : Author
Ezio Movilli
  • Function : Author
Fabio Paglialonga
  • Function : Author
Roberto Pecoits-Filho
  • Function : Author
Jeff Perl
  • Function : Author
Carol Pollock
  • Function : Author
Miguel Riella
  • Function : Author
Rukshana Shroff
  • Function : Author
Laura Solá
  • Function : Author
Henning Søndergaard
  • Function : Author
Sydney C.W. Tang
  • Function : Author
Allison Tong
  • Function : Author
Yusuke Tsukamoto
  • Function : Author
Suzanne Watnick
  • Function : Author
Matthew Weir
  • Function : Author
James Wetmore
  • Function : Author
Caroline Wilkie
  • Function : Author
Martin Wilkie
  • Function : Author

Abstract

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.
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hal-03760614 , version 1 (25-08-2022)

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Jennifer E Flythe, Tara I Chang, Martin P Gallagher, Elizabeth Lindley, Magdalena Madero, et al.. Blood pressure and volume management in dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney International, 2020, 97 (5), pp.861-876. ⟨10.1016/j.kint.2020.01.046⟩. ⟨hal-03760614⟩
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