(A) Relationship of net volume change achieved to net volume change recommended in ESRD, AKI, and AKI with CKD encounters. (B) Relationship of net volume change achieved to net volume change recommended for encounters with different categories of IDH.
Notes: The net volume change achieved is progressively less than recommended as IDH severity increases, with the exception of category 2a. Definitions of IDH categories: IDH 0: No criteria for IDH; IDH 1: Received normal saline >500 mL or albumin IV to treat hypotension; IDH 2a: MAP <65 mmHg during HD, no vasopressors given, and HD not discontinued due to hypotension; IDH 2b: Pre-HD hypotension requiring a constant dose of vasopressors to maintain BP before and during HD/UF; IDH 3: SBP decreased >50 mmHg or MAP decreased >20%; IDH 4: Vasopressor therapy initiated or dose increased, or dialysis stopped ≤2 h due to intractable hypotension. For net volume recommended, data points are plotted at the mid-point of the recommended range with slight offsets; regression lines are not offset. Negative values denote net volume removed.
Abbreviations: AKI, acute kidney injury; CKD, chronic kidney disease; ESRD, end-stage renal disease; HD, hemodialysis; IDH, intradialytic hypotension; MAP, mean arterial pressure; SBP, systolic blood pressure; UF, ultrafiltration.