11 Conversely, aggressive ultrafiltration and targeting an inappropriately low dry weight can lead to intradialytic hypotension (IDH), nausea, central nervous system dysfunction, cramping, and risks compromising vascular access and worsening residual renal function. 5 Blood pressure control without the use of pharmacotherapy is a strong predictor of survival in the population on dialysis and hence dry weight achievement, by extension, is a positive prognostic factor. The achievement of dry weight is associated with improvement in blood pressure control 8-10 and reduction in the requirement for antihypertensive medication. 4,5 Indeed, according to Agarwal et al., 6 markers of intravascular volume expansion, such as inferior vena cava diameter, blood volume monitoring (BVM), inflammatory markers, and plasma volume markers, may not be directly reflected by the clinical finding of oedema. Various studies have shown that up to 25% of patients in haemodialysis cohorts are chronically volume overloaded. Unfortunately, relying on clinical signs of volume overload and assessment of dry weight correlates poorly with a true euvolemic state. 1–3 Traditional methods of dry weight assessment have relied on clinical assessment to guide volume status. Chronic volume overload results in poorly controlled hypertension, increased cardiovascular events, and all-cause mortality. The importance of extracellular volume control and avoidance of volume overload have been well documented in relation to management of patients with chronic haemodialysis. This review article examines the use of blood volume monitoring as a tool to guide ultrafiltration during dialysis and to examine the current evidence to supports its use in assessing dry weight and in preventing intradialytic hypotension events. One such method is by the use of blood volume monitoring, which is achieved by real-time calculation of changes in relative blood volume via a cuvette placed in the arterial blood-line, which can be used to guide ultrafiltration targets during the haemodialysis session. In order to achieve this, reproducible and sensitive methods are desirable to aid objective quantification of volume status. The challenge of achieving the balance between dry weights and preventing intradialytic complications is a formidable one. Traditional methods of dry weight assessment have relied on clinical assessment to guide volume status. Chronic volume overload results in poorly controlled hypertension, increased cardiovascular events, and increased all-cause mortality. The approval process can take some time so students are strongly encouraged to apply to pursue a minor early.The importance of extracellular volume control and avoidance of volume overload has been well documented in relation to the management of patients with chronic haemodialysis. The application requires the approval of the student’s college as well as the college offering the minor. Students will not be able to earn a minor if an application has not been submitted and approved. Students interested in pursuing a minor must complete an application. Students are also encouraged to discuss the minor with the offering department. In general, each minor page explains which students are eligible to pursue the minor, any qualifications or prerequisites necessary to be eligible for the minor and the requirements to complete the minor. Students should review the information about their minor of interest in this catalog.
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Students can follow-up on long-time personal interests, satisfy intellectual curiosity generated by introductory courses, differentiate their program of study from those of fellow students or enhance their opportunities for employment or for admission to graduate or professional schools. The minor provides a traditional, well-accepted way to recognize that a student has completed a significant body of work outside the major.
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