The Japanese Journal of Clinical Dialysis Vol.26 No.2(8)

Theme Re-consideration for the Modification of Hemodialysis Therapy
Title Dialysis intolerance
Publish Date 2010/02
Author Tsutomu Kuno Ikebukuro Kuno Clinic
[ Summary ] Dialysis intolerance is similar to intradialytic hypotension (IDH). IDH may be prevented using biocompatible membranes, ultra-pure and acetate-free dialysates. Resistant cases of IDH should be treated with a combination of modalities such as isothermic dialysis, dialysate sodium profiling, and ultrafiltration profiling dialysis. Hemodiafiltration (HDF) and acetate free biofiltration (AFB) are recommended for these cases. It should be kept in mind that IDH results when a large volume of extracellular water is removed over a short period. There is limited data to make any recommendation about the benefit of extended daily dialysis or nocturnal HD to prevent the development of IDH. These liberal dialysis modalities have advantage of having slow ultrafiltration rates.
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