Key result
Continuous blood volume monitoring for dry weight in hemodialysis requires large-scale validation.
Why the study?
Adequate fluid balance control in haemodialysis patients requires reliable dry weight estimation methods, but existing continuous blood volume monitoring approaches lack large-scale verification.
How can continuous blood volume monitoring (CBVM) be used for dry weight assessment in haemodialysis patients?
How can continuous blood volume monitoring (CBVM) be used for dry weight assessment in haemodialysis patients?
Continuous blood volume monitoring offers potential methods for dry weight assessment in haemodialysis, but large-scale verification is needed before widespread clinical adoption.
CBVM for dry weight assessment in haemodialysis should not yet change practice; leaves open the need for large-scale validation trials.
There are two distinct facets of adequate fluid balance control in haemodialysis patients--estimation of dry weight (DW) as the target and adequate ultrafiltration (UF) strategy, i.e. the way to reach the target in a possibly symptom-free way. The article reviews the continuous blood volume monitoring (CBVM) based procedures to deal with the former facet-DW determination. The existing approaches are divided in three groups--methods defining certain alert value of relative blood volume (RBV) reduction, methods working with RBV response to constant UF rate, and methods evaluating dynamics of RBV response to UF pulse or chain of UF pulses. While the first and the third approaches are relatively easy to automate, the second group of methods are suitable mainly for observational evaluations only. All the discussed methods, without exception, need large-scale verification, as they all were evaluated in the majority by their authors only and on small patient cohorts.
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Lopot et al. (2007) conducted a review in Haemodialysis. Continuous blood volume monitoring (CBVM) was evaluated. Continuous blood volume monitoring methods for dry weight assessment in haemodialysis patients require large-scale verification due to evaluation primarily in small patient cohorts.
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