Hemodialysis Procedures for Stable Incident and Prevalent Patients to Optimize Hemodynamic Stability, Dialysis Dose, Electrolytes, and Fluid Balance

Stefano Stuard; Christophe Ridel; Mario Cioffi; Alijana Trost-Rupnik; Konstantin Gurevich; Marija Bojic; Yerkebulan Karibayev; Nilufar Mohebbi; Wojciech Marcinkowski; Vlasta Kupres; Jelena Maslovaric; Alon Antebi; Pedro Ponce; Mamdouh Nada; Maria Eva Baro Salvador; Jaroslav Rosenberger; Tomas Jirka; Kira Enden; Volodymyr Novakivskyy; Daniela Voiculescu; Martin Pachmann; Otto Arkossy

doi:10.20944/preprints202404.1240.v1

Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Version 1 : Received: 18 April 2024 / Approved: 18 April 2024 / Online: 18 April 2024 (10:04:00 CEST)

The demographic profile of patients transitioning from chronic kidney disease to renal replacement therapy is changing, with a higher prevalence of aging patients with multiple comorbidities such as diabetes mellitus and heart failure. Cardiovascular disease remains the leading cause of mortality in this population, exacerbated by the cardiovascular stress imposed by the HD procedure. The first year after transitioning to hemodialysis is associated with increased risks of hospitalization and mortality, particularly within the first 90–120 days, with greater vulnerability observed among the elderly. This review, based on data from clinics of Fresenius Medical Care Europe, Middle East, and Africa NephroCare, aims to optimize hemodialysis procedures to reduce mortality risk in stable incident and prevalent patients. It addresses critical aspects such as treatment duration, frequency, choice of dialysis membrane, dialysate composition, blood and dialysate flow rates, electrolyte composition, temperature control, target weight management, dialysis adequacy, and additional protocols, with a focus on mitigating prevalent intradialytic complications, particularly intradialytic hypotension prevention.

Hemodialysis procedures; hemodynamic stability; dialysis dose; dialysis electrolytes balance; dialysis fluid balance

Medicine and Pharmacology, Urology and Nephrology

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Hemodialysis Procedures for Stable Incident and Prevalent Patients to Optimize Hemodynamic Stability, Dialysis Dose, Electrolytes, and Fluid Balance

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