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Sir,

We thank Moret et al. for their interest in our recent publication and for their study of the critical blood volume specifically in minor intra-dialytic complaints such as nausea, cramps or headaches. They also found a relation between minor intra-dialytic complaints and the decline in RBV during haemodialysis. Moreover, they investigated whether a correction factor for intra-dialytic weight loss would enhance its discriminatory value.

With regards to the last item we went through our database again and found in 42 out of our 60 hypotension-prone patients undergoing treatments without any symptoms during our observational study, 50 out of 60 patients undergoing treatments with symptomatic hypotension (without any other symptoms) and 21 out of 60 patients undergoing treatments with nausea, cramps or headaches (without symptomatic hypotension or other symptoms). Our data only include 15 patients who had received treatments in all three categories: their intra-dialytic weight loss was 2.47±1.23 kg in treatments without symptoms, 2.51±1.30 kg in those with symptomatic hypotension and 2.66±1.11 kg in those with nausea, cramps or headaches (values in mean±standard deviation). The intra-individual comparison between the three treatment groups did not show any significance (Wilcoxon: P>0.3 in all three comparisons). We must, however, admit that with only 15, our number of patients was low compared with the study by Moret et al. But, at least for our subpopulation, weight loss did not differ, although the treatments were symptom-free or burdened by a major or a minor intra-dialytic complaint.

Conflict of interest statement. None declared.

Jutta Passlick-Deetjen

Fresenius Medical Care Bad Homburg Germany Email: jutta.passlick-deetjen{at}fmc-ag.com





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