The Effect of Gradient Ultrafiltration and High Sodium Dialysate on Reducing Complications During Hemodialysis / 대한신장학회잡지

ABSTRACT

OBJECTIVE: The objective of this study was to determine whether complications and nursing interventions during hemodialysis could be reduced by using gradient ultrafiltration(GUF) and high sodium dialysate(HSD). METHODS: Thirty outpatients who had been on hemodialysis for more than 3 months were enrolled. Patients received Conventional HD(Na+ 137 mEqX4 hrs, constant UF), GUF(UF 62.5%X2 hrs, UF 37.5 %X2 hrs), HSD(Na+ 145 mEqX2 hrs, Na+ 140 mEqX2 hrs) and HSUF(GUF and HSD). Each methods were prescribed for 2 weeks. The clinical features such as thirst, interdialytic weight gain, postdialytic weight loss and MAP(mean arterial pressure) and the frequency of intradialytic complications and nursing interventions were evaluated. RESULTS: The results were as followings. Interdialytic thirst, weight gain, postdialytic weight loss and MAP(pre/post HD) were not significantly different in each method. On the other hand, there was significant difference between 4 methods in serum sodium, osmolality and Hct. There were significantly fewer episodes of hypotention, muscle cramp and headache when using GUF, HSD and HSUF than CHD. The number of nursing interventions was significantly reduced in GUF, HSD and HSUF than CHD. CONCLUSION: Hemodialysis with gradient ultrafiltration and high sodium dialysate leads fewer complications and nursing interventions, more patient's well being.