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Published ahead of print on April 25, 2007
Clin J Am Soc Nephrol 2: 661-668, 2007
© 2007 American Society of Nephrology
doi: 10.2215/CJN.04171206
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Dialysis

Impact of Hemocontrol on Hypertension, Nursing Interventions, and Quality of Life: A Randomized, Controlled Trial

Clément Déziel, Josée Bouchard, Michael Zellweger, and François Madore

Nephrology Division, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada

Address correspondence to: Dr. François Madore, Research Center, Hôpital du Sacré-Cœur de Montréal, 5400 Boulevard Gouin west, Montreal, Quebec, Canada, H4J 1C5. Phone: 514-338-2222, ext. 2491; Fax: 514-338-2694; E-mail: f.madore{at}umontreal.ca

Background: Volume overload contributes to the pathogenesis of hypertension in hemodialysis (HD) patients.

Design, setting, participants, and measurements: The Hemocontrol (HC) system (Gambro), which automatically adjusts ultrafiltration rate and dialysate conductivity during dialysis, has been suggested to improve hemodynamic tolerance and thereby facilitate fluid removal. A 6-mo randomized, controlled trial was performed to test the hypothesis that the addition of the HC system to a systematic BP management protocol may lower home BP in comparison with standard HD as primary end point. Secondary end points were the number of nursing interventions during dialysis and health-related quality of life.

Results: Complete BP data were available for 36 of the 44 patients who completed the trial. There was a statistically significant overall decrease in systolic BP during the study period (P = 0.005). However, the difference between the HC group and the standard HD group was NS (HC: from 147.8 ± 21.7 to 139.8 ± 16.2 mmHg; standard HD: from 141.9 ± 19.2 to 135.2 ± 9.9 mmHg). The number of HD sessions that required nursing interventions decreased in the HC group, whereas it increased in the standard HD group (HC: 42.9% reduction; standard HD: 35.7% increase; P = 0.04). There was also a significant improvement in health-related quality of life in the HC group but not in the standard HD group.

Conclusions: These results suggest that the addition of the HC system to a systematic BP management protocol provides no additional benefit with regard to BP reduction. However, the HC system may improve the patient tolerability to dialysis.




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