Korean J Nephrol.  2002 May;21(3):450-459.

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

• Kim JA
• Yun JH
• Jang IS
• Lee MS
• Hur YS
• Shin JH
• Kwon YJ
• Pyo HJ

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.

Keyword

Hemodialysis; Complications; Gradient ultrafiltration; High sodium dialysate; Nursing interventions

MeSH Terms

Hand
Headache
Humans
Muscle Cramp
Nursing
Osmolar Concentration
Outpatients
Renal Dialysis*
Sodium*
Thirst
Ultrafiltration*
Weight Gain
Weight Loss
Sodium