{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:36:42Z","timestamp":1790800602627,"version":"4.1.0"},"reference-count":31,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,1,3]]},"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Optimal fluid management is essential when caring for a patient on haemodialysis (HD). However, if the fluid removal is too rapid, the resultant higher ultrafiltration rate (UFR) disadvantageously promotes haemodynamic instability and cardiac injury. We evaluated the effects of a rapid UFR on changes in the echocardiographic left atrial volume index (LAVI) over a period of time.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Longitudinal observational study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting and participants<\/jats:title>\n                  <jats:p>A total of 124 new patients on HD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Interventions<\/jats:title>\n                  <jats:p>Echocardiography was performed at baseline and repeated after 19.7\u2005months (range 11.3\u201323.1\u2005months). Changes in LAVI (\u0394LAVI\/year, mL\/m<jats:sup>2<\/jats:sup>\/year) were calculated. The UFR was expressed in mL\/hour\/kg, and we used the mean UFR over 30\u2005days (\u223c12\u201313 treatments).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcome measures<\/jats:title>\n                  <jats:p>The 75th centile of the \u0394LAVI\/year distribution was regarded as a \u2018pathological\u2019 increment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The mean interdialytic weight gain was 1.73\u00b10.94\u2005kg, and the UFR was 8.01\u00b13.87\u2005mL\/hour\/kg. The significant pathological increment point in \u0394LAVI\/year was 4.89\u2005mL\/m<jats:sup>2<\/jats:sup>\/year. Correlation analysis showed that \u0394LAVI\/year was closely related to the baseline blood pressure, haemoglobin level, residual renal function and UFR. According to the receiver operating characteristics curve, the \u2018best\u2019 cut-off value of UFR for predicting the pathological increment was 10\u2005mL\/hour\/kg, with an area under the curve of 0.712. In multivariate analysis, systolic blood pressure, a history of coronary artery disease, haemoglobin &lt;10\u2005g\/dL and high UFR were significant predictors. An increase of 1\u2005mL\/hour\/kg in the UFR was associated with a 22% higher risk of a worsening LAVI (OR 1.22, 95% CI 1.05 to 1.41).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>An increased haemodynamic load could affect left atrial remodelling in incident patients on HD. Thus, close monitoring and optimal control of UFR are needed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-013990","type":"journal-article","created":{"date-parts":[[2017,2,1]],"date-time":"2017-02-01T20:50:24Z","timestamp":1485982224000},"page":"e013990","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Impact of rapid ultrafiltration rate on changes in the echocardiographic left atrial volume index in patients undergoing haemodialysis: a longitudinal observational study"],"prefix":"10.1136","volume":"7","author":[{"given":"Jwa-Kyung","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Kidney Research Institute, Hallym University Sacred Heart Hospital, Anyang, Korea"},{"name":"Department of Clinical Immunology, Hallym University Sacred Heart Hospital, Anyang, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Rim","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Kidney Research Institute, Hallym University Sacred Heart Hospital, Anyang, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"GunHa","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Kidney Research Institute, Hallym University Sacred Heart Hospital, Anyang, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyung Jik","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Kidney Research Institute, Hallym University Sacred Heart Hospital, Anyang, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung Gyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Kidney Research Institute, Hallym University Sacred Heart Hospital, Anyang, Korea"},{"name":"Department of Clinical Immunology, 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