Change in definition could change results.

Labile iron in parenteral iron formulations and its potential for generating plasma nontransferrin-bound iron in dialysis patients. Incidence of side-effects associated with high-dose ferric gluconate in patients with severe chronic renal failure. A. Safety of Venofer (iron sucrose injection) administered by rapid IV push in predialysis patients. formulations: a comparative toxicologic analysis and mechanisms of cell injury. Influence of parenteral iron preparations on non-transferrin bound iron uptake, the iron regulatory protein and the expression of ferritin and the divalent metal transporter DMT-1 in HepG2 human hepatoma cells. increase of the labile iron pool in HepG2 cells by intravenous iron preparations. Sir, Tisler et al. [1] published their findings about patients' survival suffering from intradialytic hypotension (IDH). To our knowledge this is the first study to have defined IDH with these criteria. Although up to now there has not been a consensus on IDH definition, some past issues use different definitions. Begin et al. [2] selected their patients when they represented IDH in 30% of haemodialysis sessions. Hoeben et al. [3] defined IDH as at least three episodes of a decrease in systolic blood pressure (by at least 20 mm Hg to <100 mm Hg) accompanied by symptoms (dizziness, blurred vision, nausea, vomiting, cramps, or fatigue) in 50% of HD treatments over 1 month. Like another article published by these authors [4], Barnas et al. [5] defined IDH as a dialysis-induced fall in mean arterial pressure to <65 mmHg in >25% of the dialysis sessions in the previous 2 months. However, Tisler et al. characterized their frequent IDH patients with the occurrence of 10 or more hypotension episodes during the run-in time. This could have an effect on the number of patients who have divided in three groups and increase number of patients in frequent IDH group. So some patients have been noted as frequent IDH who are not really suffering from this problem as previously defined. We think regarding this issue that if authors modify their definition, the number of patients who are categorized as frequent IDH would decrease and it would affect the final results. 1. Tisler A, Akocsi K, Borbas B et al. The effect of frequent or occasional dialysis-associated hypotension on survival of patients on maintenance haemodialysis. Biofeedback regulation of ultrafiltration and dialysate conductivity for the prevention of hypotension during hemodialysis. Hemodynamics in patients with intradialytic hypotension treated with cool dialysate or midodrine. Treatment of severe intradialytic …