Journal of the American Society of Nephrology
2007 JASN IMPACT FACTOR 7.111 HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP 
    advanced
CURRENT ISSUE ARCHIVES JASN Express ONLINE SUBMISSION


This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Gong, R.
Right arrow Articles by Gouge, S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Gong, R.
Right arrow Articles by Gouge, S.

Journal of the American Society of Nephrology, Vol 3, 1808-1812, Copyright © 1993 by American Society of Nephrology

REGULAR ARTICLES

Comparison of hypertonic saline solutions and dextran in dialysis- induced hypotension

R Gong, J Lindberg, J Abrams, WR Whitaker, CE Wade and S Gouge
Letterman Army Medical Center, Presidio of San Francisco, CA.

The efficacy of three hypertonic saline solutions for treating dialysis- induced hypotension in a randomized, blinded, crossover clinical trial of 10 patients (a minimum of three cycles per solution) was compared. Dialysis-induced hypotension, defined as a decrease in systolic blood pressure of at least 10 mm Hg or systolic blood pressure less than 100 mm Hg, was treated with an iv bolus of either 10 mL of 23% saturated hypertonic saline, 30 mL of 7.5% hypertonic saline, or 30 mL of 7.5% saline with 6% dextran 70, each containing similar osmolar loads of 80, 80, and 100 mosM, respectively. All three solutions raised systolic blood pressure within 5 min (mean pretreatment systolic blood pressure, 87 mm Hg; mean posttreatment systolic blood pressure, 101 mm Hg; P < 0.05). The magnitude of the increase was greater with saturated hypertonic saline (15 mm Hg) and dextran 70 (17 mm Hg) compared with that with hypertonic saline (9 mm Hg; P < 0.05). At 10 min, dialysis- induced hypotension was less frequent with saturated hypertonic saline (incidence, 9%) compared with hypertonic saline (45%). Beyond 10 min, however, there was a trend toward a lower incidence of further dialysis- induced hypotension with dextran 70. There were no side effects. Given equal osmole loads, the more concentrated solution produced a greater increase in systolic blood pressure. The addition of an oncotic agent such as dextran may prolong the blood pressure response beyond 10 min. It was concluded that hypertonic saline solutions safely and effectively treat dialysis-induced hypotension.


This article has been cited by other articles:


Home page
 J. Am. Soc. Nephrol.Home page
G. A. Knoll, J. A. Grabowski, G. F. Dervin, and K. O'Rourke
A Randomized, Controlled Trial of Albumin versus Saline for the Treatment of Intradialytic Hypotension
J. Am. Soc. Nephrol., February 1, 2004; 15(2): 487 - 492.
[Abstract] [Full Text] [PDF]

Home page
 Nephrol Dial TransplantHome page
R. W. Nette, H. P. Krepel, A. H. van den Meiracker, W. Weimar, and R. Zietse
Specific effect of the infusion of glucose on blood volume during haemodialysis
Nephrol. Dial. Transplant., July 1, 2002; 17(7): 1275 - 1280.
[Abstract] [Full Text] [PDF]

Home page
 J. Am. Soc. Nephrol.Home page
F. M. VAN DER SANDE, A. J. LUIK, J. P. KOOMAN, V. VERSTAPPEN, and K. M. L. LEUNISSEN
Effect of Intravenous Fluids on Blood Pressure Course during Hemodialysis in Hypotensive-Prone Patients
J. Am. Soc. Nephrol., March 1, 2000; 11(3): 550 - 555.
[Abstract] [Full Text] [PDF]


HOME CURRENT ISSUE ARCHIVES JASN Express ONLINE SUBMISSION AUTHOR INFO
EDITORIAL BOARD SUBSCRIBE FEEDBACK ALERTS HELP

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673