The Role of Ultrafiltration Therapy on Blood  Pressure of Hypertensive Chronic Hemodialysis  Children

Caner KABASAKAL

Article Details

The Role of Ultrafiltration Therapy on Blood Pressure of Hypertensive Chronic Hemodialysis Children

Authors:

Caner KABASAKAL

Publisher:

TUBITAK

Journal:

Turkish Journal of Medical Sciences 1998 Vol.28 Issue 5, pp.537-540

Document Type:

Article

Publication Date:

4/1998

Document Language:

Turkish

Document ID (Org No.):

2000758268

Frequency:

Bimonthly

eISSN:

1303-6165

pISSN:

1300-0144

Keywords:

Children; hemodialysis; hypertension; hypervolemia; ultrafiltration.

Abstract:

 

Hypervolemia is supposed to be  the principal factor in hypertension in chronic  hemodialysis adults. In this study, the role of  intensive ultrafiltration (UF) treatment to  reduce hypertension due to hypervolemia in  hemodialysis children was investigated. The  inferior vena cava (IVC) was also evaluated as  an index of UF therapy. Twenty-three  hemodialysis children with the mean age  10.6±3.1 years were classified due to their  blood pressure status. IVC measurements  were performed with 2-D echocardiography  and inferior vena cava index (IVCI) was  calculated as diameter of inferior vena cava  (mm)/ body surface area (m 2 ). UF therapy  was applied to each hypervolemic patient for  four successive days and all of the patients  were followed up for 4 weeks. Plasma levels  of atrial natriuretic peptide (RIA),  noradrenalin (high performance liquid  chromotography) and plasma renin activity  (RIA) of three patients having persistent  hypertension were investigated. IVCI and  plasma atrial natriuretic peptide levels of 12  healthy children were studied as a control  group.  At the begining of the study, 11 patients had  hypertension and 14 patients had high IVCI.  14 hypervolemic children had UF therapy.  Eleven patients responded to UF therapy and  had normal blood pressures. After 4 weeks  of follow up period 12, patients were again  found to have hypertension. Following UF,  hypertension was persisted in 3 of them.  Since IVCI and ANP levels of these three  patients were high, hypervolemia or some  other factors was thought to be responsible  for hypertension. Volume overload was  found to be the most important factor in the  pathogenesis of HT in hemodialysis children.  UF was effective in reducing hypertension.  IVCI might be a reliable parameter to control  ultrafiltration therapy in the management of  hypervolemic hemodialysis children.

 

Hypervolemia is supposed to be  the principal factor in hypertension in chronic  hemodialysis adults. In this study, the role of  intensive ultrafiltration (UF) treatment to  reduce hypertension due to hypervolemia in  hemodialysis children was investigated. The  inferior vena cava (IVC) was also evaluated as  an index of UF therapy. Twenty-three  hemodialysis children with the mean age  10.6±3.1 years were classified due to their  blood pressure status. IVC measurements  were performed with 2-D echocardiography  and inferior vena cava index (IVCI) was  calculated as diameter of inferior vena cava  (mm)/ body surface area (m 2 ). UF therapy  was applied to each hypervolemic patient for  four successive days and all of the patients  were followed up for 4 weeks. Plasma levels  of atrial natriuretic peptide (RIA),  noradrenalin (high performance liquid  chromotography) and plasma renin activity  (RIA) of three patients having persistent  hypertension were investigated. IVCI and  plasma atrial natriuretic peptide levels of 12  healthy children were studied as a control  group.  At the begining of the study, 11 patients had  hypertension and 14 patients had high IVCI.  14 hypervolemic children had UF therapy.  Eleven patients responded to UF therapy and  had normal blood pressures. After 4 weeks  of follow up period 12, patients were again  found to have hypertension. Following UF,  hypertension was persisted in 3 of them.  Since IVCI and ANP levels of these three  patients were high, hypervolemia or some  other factors was thought to be responsible  for hypertension. Volume overload was  found to be the most important factor in the  pathogenesis of HT in hemodialysis children.  UF was effective in reducing hypertension.  IVCI might be a reliable parameter to control  ultrafiltration therapy in the management of  hypervolemic hemodialysis children.

Article Details

The Role of Ultrafiltration Therapy on Blood Pressure of Hypertensive Chronic Hemodialysis Children

Authors: Caner KABASAKAL

Publisher: TUBITAK

Journal: Turkish Journal of Medical Sciences 1998 Vol.28 Issue 5, pp.537-540

Document Type: Article

Publication Date: 4/1998

Document Language: Turkish

Document ID (Org No.): 2000758268

Frequency: Bimonthly

eISSN: 1303-6165

pISSN: 1300-0144

Children; hemodialysis; hypertension; hypervolemia; ultrafiltration.

Issues

Authors:

Caner KABASAKAL

Publisher:

TUBITAK

Journal:

Turkish Journal of Medical Sciences 1998 Vol.28 Issue 5, pp.537-540

Document Type:

Article

Publication Date:

4/1998

Document Language:

Turkish

Document ID (Org No.):

2000758268

Frequency:

Bimonthly

eISSN:

1303-6165

pISSN:

1300-0144