The Role of Net Na and H2O Flux in the Morbidity of Hemodialysis and Hemofiltration
The most objective and serious morbidity associated with hemodialysis (HD) and with hemofiltration (HF) is symptomatic hypotension, which is still reported to occur in 30% of HD treatments.(1) The cause undoubtedly is multifactorial and, as recently reviewed by Henderson,(2) may include (1) osmotic and ultrafiltration-induced changes in extracellular fluid volume (VE); (2) autonomic neuropathy; (3) toxicity of acetate and acute changes in acid-base equilibrium; (4) membrane toxicity; and (5) other as yet undefined factors. The purpose of this chapter is consideration of the relationship of net Na and H2O flux and changes in VE to morbidity.
KeywordsAutonomic Neuropathy Donnan Ratio Filtration Fraction Extracellular Fluid Volume Ultrafiltration Rate
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