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https://repository.monashhealth.org/monashhealthjspui/handle/1/29324| Title: | Blood pressure and volume management in dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. | Authors: | Wilkie M.;Madero M.;Sarafidis P.A.;Unruh M.L.;Wang A.Y.-M.;Weiner D.E.;Cheung M.;Jadoul M.;Winkelmayer W.C.;Adragao T.;Anumudu S.J.;Chan C.T.;Cheung A.K.;Costanzo M.R.;Dasgupta I.;Davenport A.;Davies S.J.;Dekker M.J.E.;Dember L.M.;Gallego D.;Gomez R.;Hawley C.M.;Hecking M.;Iseki K.;Jha V.;Kooman J.P.;Kovesdy C.P.;Lacson E.;Liew A.;Lok C.E.;McIntyre C.W.;Mehrotra R.;Miskulin D.C.;Movilli E.;Paglialonga F.;Pecoits-Filho R.;Perl J.;Pollock C.A.;Riella M.C.;Rossignol P.;Shroff R.;Sola L.;Sondergaard H.;Tang S.C.W.;Tong A.;Tsukamoto Y.;Watnick S.;Weir M.R.;Wetmore J.B.;Wilkie C.;Lindley E.;Polkinghorne K.R. ;Flythe J.E.;Chang T.I.;Gallagher M.P. | Monash Health Department(s): | Nephrology | Institution: | (Flythe) University of North Carolina Kidney Center, Division of Nephrology and Hypertension, Department of Medicine, UNC School of Medicine, Chapel Hill, NC, United States (Flythe) Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC, United States (Chang) Division of Nephrology, Stanford University School of Medicine, Palo Alto, CA, United States (Gallagher) George Institute for Global Health, Renal and Metabolic Division, Camperdown, Australia (Gallagher) Concord Repatriation General Hospital, Department of Renal Medicine, Sydney, Australia (Lindley) Department of Renal Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom (Madero) Department of Medicine, Division of Nephrology, National Institute of Cardiology "Ignacio Chavez", Mexico City, Mexico (Sarafidis) Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece (Unruh) Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, United States (Wang) Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong (Weiner) William B. Schwartz Division of Nephrology, Tufts Medical Center, Boston, MA, United States (Cheung) KDIGO, Brussels, Belgium (Jadoul) Department of Nephrology, Cliniques universitaires Saint-Luc, Universite catholique de Louvain, Brussels, Belgium (Winkelmayer) Selzman Institute for Kidney Health, Section of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, TX, United States (Polkinghorne) Department of Nephrology, Monash Health, Clayton, Melbourne, Australia (Polkinghorne) Department of Medicine, Monash University, Clayton, Melbourne, Australia (Polkinghorne) Department of Epidemiology and Preventive Medicine, Monash University, Prahan, Melbourne, Australia | Issue Date: | 22-Apr-2020 | Copyright year: | 2020 | Publisher: | Elsevier B.V. | Place of publication: | Netherlands | Publication information: | Kidney International. 97 (5) (pp 861-876), 2020. Date of Publication: May 2020. | Journal: | Kidney International | 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.Copyright © 2020 International Society of Nephrology | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1016/j.kint.2020.01.046 | PubMed URL: | 32278617 [http://www.ncbi.nlm.nih.gov/pubmed/?term=32278617] | ISSN: | 0085-2538 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/29324 | Type: | Conference Paper | Subjects: | midodrine peritoneal dialysis fluid propranolol sertraline spironolactone wearable computer dipeptidyl carboxypeptidase inhibitor blood pressure blood pressure measurement blood pressure monitoring blood pressure variability blood volume blood volume determination body weight cardiovascular disease clinical decision making continuous ambulatory peritoneal dialysis diet restriction dietary compliance drug choice drug efficacy drug use exercise extracellular space heart arrhythmia heart failure hemodiafiltration hemodialysis hypertension hypervolemia hypotension kidney function lifestyle medical nutritional status patient preference peritoneal dialysis practice guideline prescription quality of life remote sensing renal replacement therapy sodium restriction ultrafiltration amezinium metilsulfate amlodipine angiotensin receptor antagonist antihypertensive agent argipressin atenolol beta adrenergic receptor blocking agent calcium channel blocking agent carnitine carvedilol diuretic agent droxidopa fludrocortisone fosinopril icodextrin lisinopril metoprolol |
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