effect of increasing blood flow rate on dialysis adequacy in hemodialysis patients

ABSTRACT

One of the morbidity and mortality determinants of the dialysis patients is inadequacy of dialysis. Increasing the dialysis efficacy improves patient's prognosis. The aim of this study was to assess the effect of increasing blood flow on the adequacy of dialysis in dialysis department of Ekbatan hospital of Hamadan. This before-after design study was performed on 42 patients First, data was collected about the following parameters patient's weigh; before and after hemodialysis. ultrafiltration, urea before and after hemodialysis, the time of dialysis, percentage of filter clearance and speed of dialysate. Then the patient was attached to the dialysis machine and a sample of blood was taken. The pumpage of dialysis machine in the first session was put on 200 ml/min and in the second session on 250 ml/min. During the hemodialysis, the hemodynamic status and vital signs of patient's were controlled. When hemodialysis finished a blood sample was taken from the artery set, in a section before dialyzer [4 blood sample for each patients], weight was controlled again and the sample was sent to a laboratory for urea control. Then the efficiency of dialysis was determined. Descriptive and analytical statistics were used for analysis of the data. Results showed the mean KT/V [K=Clearance dialyzer T= Time V=Volume of distribation of urea] of patients whose pumping cycle were 200 ml/min, had 0.943 +/- 0.335 and URR [Urea Reduction Ratio] 53.3 +/- 13.5 wereas mean KT/V patients with 250 pumping cycle had 1.195 +/- 0.45 and URR 60.17 +/- 10.47. Paired t-test with%95 confidence interval showed that there was a significant difference in dialysis efficiency between the two groups [p<0.05]. Our data suggests that increasing blood flow rate by 25% of previous flow rate is effective in achieving higher dialysis adequacy in hemodialysis patients