Table 2.
Postdialysis target weight needs to be regularly assessed because an inappropriately low target increases the risk of intradialytic hypotension
Assessment | Volume overload | Volume depleted |
---|---|---|
History | ↑Dietary salt intake | ↓Appetite |
↑Dyspnea | Diarrhea/vomiting | |
Examination | No postural hypotension | Postural hypotension |
↑Blood pressure | ↓Blood pressure | |
↑Weight trend | ↓Weight trend | |
↑Neck veins | ↓Neck veins | |
↑Peripheral edema | No edema | |
Laboratory | Low albumin | ↑Albumin |
↑Natriuretic peptides | ↓Natriuretic peptides | |
↑Serum CA125 | Normal serum CA125 | |
Imaging chest X ray | ↑CTR | Normal/↓CTR |
Septal lines | ||
Kerley B lines | ||
Lung ultrasound | >10 B lines | <5 B lines |
Abdominal ultrasound | <50% collapse IVC | >50% IVC collapse |
Bioimpedance | ↑ECW/ICW | ↓ECW/ICW |
Dialysis session RBV | Flat line | Rapid decline |
Dialysis session VO2 | Stable O2 saturation | ↓O2 saturation |
CA125, cancer antigen 125; CTR, cardio-thoracic ratio; ECW, extracellular water, ICW, intracellular water; RBV, relative blood volume; VO2, venous oxygen saturation.