A meta-analysis of sodium profiling techniques and the impact on intradialytic hypotension
Nina Dunne
Hemodialysis has improved in recent years, however, despite such improvements, intradialytic hypotensive episodes still persistwhich can lead to a reduction in the overall effectiveness of the treatment. Profiling sodium levels during dialysis can improve vascular refilling and therefore may prevent hypotensive events. A number of profilingmethods exist and this meta-analysis set out to examine the effectiveness of thesemethods. Methods To assess the effectiveness of hemodialysis sodium profiling techniques. A review and meta-analysis analytical framework was used. A search was conducted using Medline, Embase and CINAHL, Scopus and Web of Knowledge between 1946 and 2014 of published English-language peer reviewed randomized control studies. In total 10 articles were retrieved and included in the review. All data was abstracted with a standardized data collection form. Stata 11.2 (Stata Corp) was used to analyse the data. Actual numbers of hypotensive events were pooled between studies. Analysis of subgroups was performed on sodium profile type. The data were further investigated using meta-regression. Publication bias was also tested. Findings Stepwise profiling was shown to be statistically significantly effective in reducing intradialytic episodes. Results demonstrated that linear sodium profiling was not effective in reducing hypotensive events during dialysis. Discussion This review has shown that using stepwise profiling is more effective at reducing intra-dialytic symptoms than other profiling methods. There was no evidence that linear profiling method was any more effective than conventional dialysis and in fact the results showed the reverse.
Hemodialysis International
https://doi.org/10.1111/hdi.12488
This is the peer reviewed version of the following article: Dunne, N. (2017), A meta-analysis of sodium profiling techniques and the impact on intradialytic hypotension. Hemodialysis International, 21: 312–322, which has been published in final form at http://onlinelibrary.wiley.com/wol1/doi/10.1111/hdi.12488/abstract. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving
intra-dialytic hypotension
renal hypotension
sodium profiling
10.1111/hdi.12488Licence: Unspecified
main document HDI-16-0146. R1 Version.pdfAccepted author manuscript, 321 KBLicence: Unspecified
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Dunne, N. (2016). A meta-analysis of sodium profiling techniques and the impact on intradialytic hypotension. Hemodialysis International, 21(3), 312-322. https://doi.org/10.1111/hdi.12488
Dunne, Nina. / A meta-analysis of sodium profiling techniques and the impact on intradialytic hypotension. In: Hemodialysis International. 2016 ; Vol. 21, No. 3. pp. 312-322.
@article{2e12a8476c7f4e58874a71fa1c5eba5c,
title = "A meta-analysis of sodium profiling techniques and the impact on intradialytic hypotension",
abstract = "Hemodialysis has improved in recent years, however, despite such improvements, intradialytic hypotensive episodes still persistwhich can lead to a reduction in the overall effectiveness of the treatment. Profiling sodium levels during dialysis can improve vascular refilling and therefore may prevent hypotensive events. A number of profilingmethods exist and this meta-analysis set out to examine the effectiveness of thesemethods. Methods To assess the effectiveness of hemodialysis sodium profiling techniques. A review and meta-analysis analytical framework was used. A search was conducted using Medline, Embase and CINAHL, Scopus and Web of Knowledge between 1946 and 2014 of published English-language peer reviewed randomized control studies. In total 10 articles were retrieved and included in the review. All data was abstracted with a standardized data collection form. Stata 11.2 (Stata Corp) was used to analyse the data. Actual numbers of hypotensive events were pooled between studies. Analysis of subgroups was performed on sodium profile type. The data were further investigated using meta-regression. Publication bias was also tested. Findings Stepwise profiling was shown to be statistically significantly effective in reducing intradialytic episodes. Results demonstrated that linear sodium profiling was not effective in reducing hypotensive events during dialysis. Discussion This review has shown that using stepwise profiling is more effective at reducing intra-dialytic symptoms than other profiling methods. There was no evidence that linear profiling method was any more effective than conventional dialysis and in fact the results showed the reverse.",
keywords = "Hemodialysis, intra-dialytic hypotension, meta-analysis, renal hypotension, sodium profiling",
author = "Nina Dunne",
note = "This is the peer reviewed version of the following article: Dunne, N. (2017), A meta-analysis of sodium profiling techniques and the impact on intradialytic hypotension. Hemodialysis International, 21: 312–322, which has been published in final form at http://onlinelibrary.wiley.com/wol1/doi/10.1111/hdi.12488/abstract. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving",
doi = "10.1111/hdi.12488",
journal = "Hemodialysis International",
Dunne, N 2016, 'A meta-analysis of sodium profiling techniques and the impact on intradialytic hypotension', Hemodialysis International, vol. 21, no. 3, pp. 312-322. https://doi.org/10.1111/hdi.12488
A meta-analysis of sodium profiling techniques and the impact on intradialytic hypotension. / Dunne, Nina.
In: Hemodialysis International, Vol. 21, No. 3, 12.09.2016, p. 312-322.
T1 - A meta-analysis of sodium profiling techniques and the impact on intradialytic hypotension
AU - Dunne, Nina
N1 - This is the peer reviewed version of the following article: Dunne, N. (2017), A meta-analysis of sodium profiling techniques and the impact on intradialytic hypotension. Hemodialysis International, 21: 312–322, which has been published in final form at http://onlinelibrary.wiley.com/wol1/doi/10.1111/hdi.12488/abstract. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving
N2 - Hemodialysis has improved in recent years, however, despite such improvements, intradialytic hypotensive episodes still persistwhich can lead to a reduction in the overall effectiveness of the treatment. Profiling sodium levels during dialysis can improve vascular refilling and therefore may prevent hypotensive events. A number of profilingmethods exist and this meta-analysis set out to examine the effectiveness of thesemethods. Methods To assess the effectiveness of hemodialysis sodium profiling techniques. A review and meta-analysis analytical framework was used. A search was conducted using Medline, Embase and CINAHL, Scopus and Web of Knowledge between 1946 and 2014 of published English-language peer reviewed randomized control studies. In total 10 articles were retrieved and included in the review. All data was abstracted with a standardized data collection form. Stata 11.2 (Stata Corp) was used to analyse the data. Actual numbers of hypotensive events were pooled between studies. Analysis of subgroups was performed on sodium profile type. The data were further investigated using meta-regression. Publication bias was also tested. Findings Stepwise profiling was shown to be statistically significantly effective in reducing intradialytic episodes. Results demonstrated that linear sodium profiling was not effective in reducing hypotensive events during dialysis. Discussion This review has shown that using stepwise profiling is more effective at reducing intra-dialytic symptoms than other profiling methods. There was no evidence that linear profiling method was any more effective than conventional dialysis and in fact the results showed the reverse.
AB - Hemodialysis has improved in recent years, however, despite such improvements, intradialytic hypotensive episodes still persistwhich can lead to a reduction in the overall effectiveness of the treatment. Profiling sodium levels during dialysis can improve vascular refilling and therefore may prevent hypotensive events. A number of profilingmethods exist and this meta-analysis set out to examine the effectiveness of thesemethods. Methods To assess the effectiveness of hemodialysis sodium profiling techniques. A review and meta-analysis analytical framework was used. A search was conducted using Medline, Embase and CINAHL, Scopus and Web of Knowledge between 1946 and 2014 of published English-language peer reviewed randomized control studies. In total 10 articles were retrieved and included in the review. All data was abstracted with a standardized data collection form. Stata 11.2 (Stata Corp) was used to analyse the data. Actual numbers of hypotensive events were pooled between studies. Analysis of subgroups was performed on sodium profile type. The data were further investigated using meta-regression. Publication bias was also tested. Findings Stepwise profiling was shown to be statistically significantly effective in reducing intradialytic episodes. Results demonstrated that linear sodium profiling was not effective in reducing hypotensive events during dialysis. Discussion This review has shown that using stepwise profiling is more effective at reducing intra-dialytic symptoms than other profiling methods. There was no evidence that linear profiling method was any more effective than conventional dialysis and in fact the results showed the reverse.
KW - Hemodialysis
KW - intra-dialytic hypotension
KW - meta-analysis
KW - renal hypotension
KW - sodium profiling
U2 - 10.1111/hdi.12488
DO - 10.1111/hdi.12488
JO - Hemodialysis International
JF - Hemodialysis International
Dunne N. A meta-analysis of sodium profiling techniques and the impact on intradialytic hypotension. Hemodialysis International. 2016 Sep 12;21(3):312-322. https://doi.org/10.1111/hdi.12488