{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T22:30:11Z","timestamp":1768948211409,"version":"3.49.0"},"reference-count":17,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T00:00:00Z","timestamp":1762646400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T00:00:00Z","timestamp":1762646400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hemodialysis International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>High ultrafiltration rate is a common clinical problem in those undergoing maintenance dialysis and is associated with myocardial injury and increased mortality. The safety of the downward sloping profile of ultrafiltration in those with high ultrafiltration rates is currently unknown. The aim of the present study is to compare mean arterial pressure trends and dialysis\u2010associated high\u2010sensitivity Troponin I changes among patients with high ultrafiltration rates undergoing constant and profiled ultrafiltration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The enrolled study participants were patients on maintenance dialysis thrice weekly with ultrafiltration rates &gt;\u200913\u2009mL\/kg\/h and without known cardiac disease. During the study month, they received six sessions with constant ultrafiltration and six sessions with downward sloping profiled ultrafiltration. Pre\u2010to\u2010post HD hs TnI change, blood pressures, and intradialytic hypotension episodes were measured during all 12 sessions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      A total of 42 study participants with 504 dialysis sessions were analyzed. The mean age of study participants was 41.3 (\u00b112.1) years, two\u2010thirds were male, and up to 17% had diabetes mellitus. The mean ultrafiltration volume was 17.4 (\u00b13.2) mL\/kg\/h. Mean arterial pressures and intradialytic hypotension did not differ significantly between constant and profiled sessions, except for trends toward higher pressures at the post\u2010HD timepoint in profiled UF (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.08). Upon comparing \u0394 Post\u2010Pre\u2010HD hs Tn I of constant versus profiled ultrafiltration, constant sessions showed a median rise of troponin, ranging from 8 to 21\u2009ng\/mL from pre\u2010 to post\u2010HD, and profiled sessions showed a median fall, ranging from 11 to 21\u2009ng\/mL from pre\u2010 to post\u2010HD during profiled UF sessions (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Multivariate logistic regression analysis showed that constant UF type was associated with 27 times greater odds of developing a 10% rise in high\u2010sensitivity troponin.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In maintenance dialysis patients with high ultrafiltration, constant fluid removal is associated with a rise in hs Tn I, and a downward sloping profile may be safer than constant fluid removal.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration<\/jats:bold>\n                      : Clinical Trials Registry of India (CTRI): CTRI\/2023\/02\/049618.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hdi.70030","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T06:21:23Z","timestamp":1762755683000},"page":"267-274","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Constant Fluid Removal Associates With Greater Risk of Elevated High\u2010Sensitivity Troponin I Than Downward Sloping Profile Among Maintenance Dialysis Patients With\u00a0High Ultrafiltration"],"prefix":"10.1111","volume":"30","author":[{"given":"Shivani","family":"Kanwal","sequence":"first","affiliation":[{"name":"Department of Nephrology Dr. Ram Manohar Lohia Institute of Medical Sciences  Lucknow India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5733-4218","authenticated-orcid":false,"given":"Namrata","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Nephrology Dr. Ram Manohar Lohia Institute of Medical Sciences  Lucknow India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abhilash","family":"Chandra","sequence":"additional","affiliation":[{"name":"Department of Nephrology Dr. Ram Manohar Lohia Institute of Medical Sciences  Lucknow India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manish Raj","family":"Kulshreshta","sequence":"additional","affiliation":[{"name":"Department of Biochemistry Dr. Ram Manohar Lohia Institute of Medical Sciences  Lucknow India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sai","family":"Saran","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine Sanjay Gandhi Postgraduate Institute of Medical Sciences  Lucknow India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prabhaker","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Sanjay Gandhi Postgraduate Institute of Medical Sciences  Lucknow India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,9]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfz174"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(14)61601\u20109"},{"key":"e_1_2_11_4_1","volume-title":"2024 USRDS Annual Data Report: Epidemiology of kidney disease in the United States","author":"United States Renal Data System","year":"2024"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2015.141"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2010.383"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.34067\/KID.0001322022"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.2000.8280"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40620\u2010020\u201000862\u20106"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000445360"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/4214429"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882\u2010020\u201002103\u20101"},{"issue":"2","key":"e_1_2_11_13_1","first-page":"150","article-title":"The Initial Attitudes of Patients Toward Longer Maintenance Hemodialysis","volume":"56","author":"Gaughan W. 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